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					  UNIVERSITY OF MINNESOTA
    GRADUATE MEDICAL
        EDUCATION

        2010-2011
 FELLOWSHIP POLICY MANUAL




Department of Pediatrics
Developmental-Behavioral
Pediatrics Fellowship Program
Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




Introduction/Explanation of Manual
On behalf of the faculty and staff, welcome to the Department of Pediatrics at the University of
Minnesota. We hope that the time you spend in the Developmental-Behavioral Pediatrics Fellowship
Program will be both educational and enjoyable.

This Fellowship Addendum outlines policies and procedures specific to your training program. Policies
in this addendum have been developed in accordance with standards set by the American Board of
Pediatrics (ABP) and the Accreditation Council for Graduate Medical Education (ACGME), and are
subject to periodic review and change by the faculty, program director, and department chair.

Refer to the Institution Manual and the Pediatric Program Policy Manual for further policies and
procedures.

The Institution Manual can be found on the GME website at:
http://www.gme.umn.edu/residents/instpolicyman/home.html

The Pediatric Program Policy Manual can be found on the Pediatric Residency website at:
http://www.pedsres.umn.edu/current/programmanual/home.html



Mission Statement of the University of Minnesota Department of
Pediatrics’ Fellowships
The Department of Pediatrics at the University of Minnesota promotes excellence in academic
subspecialty training with an emphasis on producing academic leaders who generate the new knowledge
required to provide the best care for infants, children, and ado lescents.

We will accomplish this through:
   Recruiting fellows with outstanding academic potential and commitment.
   Providing state-of-the-art clinical training.
   Providing exceptional training and mentorship in basic, translational, clinical, and epidemiologic
      research, medical education, academic leadership, and advocacy for pediatric health.
   Ensuring a scholarly work product during fellowship which serves to facilitate fellows’
      professional transition into academic faculty positions.




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




Mission Statement of the University of Minnesota Developmental-
Behavioral Pediatrics Fellowship
Insert your program’s mission statement




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




Table of Contents
Introduction/Explanation of Manual ........................................................................................................... 2
Mission Statement of the University of Minnesota Department of Pediatrics’ Fellowships ...................... 2
Mission Statement of the University of Minnesota Developmental- Behavioral Pediatrics Fellowship ... 3
Table of Contents ........................................................................................................................................ 4
SECTION 1 - STUDENT SERVICES ....................................................................................................... 7
   MEDICAL SCHOOL REGISTRATION ............................................................................................... 7
   TUITION AND FEES ............................................................................................................................ 7
   LATE FEES ............................................................................................................................................ 7
   ADDITIONAL COURSES..................................................................................................................... 7
   CAMPUS MAIL ..................................................................................................................................... 7
   CAREER SEARCH RESOURCES ........................................................................................................ 8
   E-MAIL................................................................................................................................................... 8
   HIPAA TRAINING ................................................................................................................................ 8
   PAGERS ................................................................................................................................................. 8
   RESIDENT ASSISTANCE PROGRAM (RAP) .................................................................................... 8
SECTION 2 - BENEFITS........................................................................................................................... 8
   EDUCATIONAL EXPENSE ALLOWANCE ....................................................................................... 9
   INSURANCE.......................................................................................................................................... 9
     Health and Dental Insurance Coverage............................................................................................... 9
     Professional Liability Insurance.......................................................................................................... 9
     Life Insurance ..................................................................................................................................... 9
     Voluntary Life Insurance .................................................................................................................... 9
     Long-Term Disability Insurance ......................................................................................................... 9
     Short-Term Disability Insurance......................................................................................................... 9
     Insurance Coverage Changes (refer also to the Pediatric Program Manual) ...................................... 9
   LAUNDRY SERVICES ......................................................................................................................... 9
   LEAVE POLICIES ............................................................................................................................... 10
     POLICY ON EFFECT OF LEAVE FOR SATISFYING COMPLETION OF PROGRAM ........... 10
     Vacation ............................................................................................................................................ 10
     Holidays ............................................................................................................................................ 10
     Interviewing Time............................................................................................................................. 10
     Professional/Academic Leave........................................................................................................... 10
     Parental: Maternal/Paternal/Partner Leave ....................................................................................... 10
     Sick Leave......................................................................................................................................... 11
     Medical Leave................................................................................................................................... 11
     Personal Leave of Absence ............................................................................................................... 11
   MEAL ALLOTMENT .......................................................................................................................... 12
   PARKING ............................................................................................................................................. 12
   PHOTOCOPYING PRIVILEGES........................................................................................................ 12
   SCRUB SUITS, LABCOATS, AND ID BADGES ............................................................................. 12
   STIPENDS ............................................................................................................................................ 12
   PAYCHECKS/DIRECT DEPOSIT ...................................................................................................... 12
   TAX INFORMATION ......................................................................................................................... 13
   WORKER’S COMPENSATION POLICY AND PROCEDURES ..................................................... 13




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




SECTION 3 - Institution Responsibilities ................................................................................................ 13
SECTION 4 - DISCIPLINARY AND GRIEVANCE PROCEDURES ................................................... 13
  GRIEVANCE PROCEDURES AND DUE PROCESS ....................................................................... 13
  HOUSE STAFF SUBSTANCE USE/ABUSE POLICY...................................................................... 15
SECTION 5 - GENERAL POLICIES AND PROCEDURES ................................................................. 16
  SUBSPECIALTY TRAINING REQUIREMENTS FOR FELLOWS ................................................. 17
    Academic Expectations for Pediatric Fellows .................................................................................. 17
    Core Curriculum ............................................................................................................................... 17
    Scholarly Activities........................................................................................................................... 18
    Work Product of Scholarly Activity ................................................................................................. 18
    Scholarship Oversight Committee (SOC)......................................................................................... 19
    External Oversight ............................................................................................................................ 20
    Responsibilities of the Training Program Director ........................................................................... 20
  CURRICULUM .................................................................................................................................... 21
    Conferences....................................................................................................................................... 21
    Teaching Responsibilities ................................................................................................................. 36
  PROGRAM GOALS AND OBJECTIVES .......................................................................................... 36
  ACGME CORE COMPETENCIES ..................................................................................................... 36
  PROCEDURES..................................................................................................................................... 37
  DUTY HOURS ..................................................................................................................................... 37
  ON-CALL ............................................................................................................................................. 38
  SCHEDULING ..................................................................................................................................... 38
  ABSENCE COVERAGE...................................................................................................................... 38
  BACK-UP POLICY.............................................................................................................................. 38
  MONITORING OF FELLOW WELL-BEING .................................................................................... 39
  SUPERVISION OF FELLOWS ........................................................................................................... 39
  EVALUATION..................................................................................................................................... 39
    Steps in the Evaluation Process ........................................................................................................ 39
    Possible Outcomes of Review by the Resident Review Committee (RRC) ..................................... 40
    Types of Evaluations......................................................................................................................... 40
    Evaluation Confidentiality ................................................................................................................ 41
    Types of Assessments ....................................................................................................................... 41
    Annual Program Review ................................................................................................................... 42
    Subspecialty In-Training Examination (SITE) ................................................................................. 42
    Residency Management Suite (RMS)............................................................................................... 42
  TRAINING/GRADUATION REQUIREMENTS ................................................................................ 42
  TEACHING MEDICAL STUDENTS ................................................................................................. 43
    ACLS/BLS/PALS RECERTIFICATION......................................................................................... 43
    AMA POLICY FOR ACCEPTING GIFTS ..................................................................................... 43
    MEDICAL RECORD/DICTATION COMPLETION ..................................................................... 43
    CONTINUITY OF CARE ................................................................................................................ 43
    DEMONSTRATION OF ENGLISH LANGUAGE PROFICIENCY BY NON-NATIVE
    SPEAKERS OF ENGLISH .............................................................................................................. 43
    GUIDELINES FOR PROFESSIONAL DRESS .............................................................................. 43
    PROFESSIONAL INTRODUCTION GUIDELINES ..................................................................... 43
    MEDICAL LICENSURE ................................................................................................................ 43




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




    MOONLIGHTING POLICY:........................................................................................................... 44
    ON CALL ROOMS, SUPPORT SERVICES, LABORATORY/PATHOLOGY/RADIOLOGY
    SERVICES........................................................................................................................................ 44
    MEDICAL RECORDS ..................................................................................................................... 44
    SECURITY/SAFETY ....................................................................................................................... 44
    UNAUTHORIZED LEAVE ............................................................................................................. 44
SECTION 6 – ADMINSTRATION ......................................................................................................... 45
  DEPARTMENT OF PEDIATRICS: ADMINISTRATION................................................................. 45
    Head of the Department of Pediatrics ............................................................................................... 45
  DEPARTMENT OF PEDIATRICS: DIVISION OF ACADEMIC GENERAL PEDIATRICS .. Error!
  Bookmark not defined.Error! Bookmark not defined.44
    Director, Developmental-Behavioral Pediatrics Fellowship Program.............................................. 44
    Coordinator, Developmental-Behavioral Pediatrics Fellowship Program........................................ 44
  DEPARTMENT OF PEDIATRICS: PAYROLL ................................................................................. 45
Confirmation of Receipt of your Fellowship Addendum for Academic Year 2010-2011 ....................... 47




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




SECTION 1 - STUDENT SERVICES
(Please refer to Institution Policy Manual at
http://www.med.umn.edu/gme/residents/instpolicyman/home.html for Medical School Policies on the
following: Academic Health Center (AHC) Portal Access; Child Care; Computer Discount/University
Bookstore; Credit Union; Disability Accommodations; Expression Connection; Legal Services; Library
Services; Medical School Campus Maps; Resident Assistance Program; Tuition Reciprocity; University
Card (UCard); University Events Box Office; University Recreation Sports Center(s))

MEDICAL SCHOOL REGISTRATION
Refer to Pediatric Program Manual at:
http://www.pedsres.umn.edu/current/programmanual/services/registration/home.html

TUITION AND FEES
Refer to Pediatric Program Manual at:
http://www.pedsres.umn.edu/current/programmanual/services/tuition/home.html
For fellows pursuing a Masters of Public Health (MPH) degree : Through the grant supporting your
fellowship training, you receive some funding to defray the cost of tuition and fees for courses directly
related to your MPH degree. Deb Seyfer will need to access (via One Stop) or receive a hard copy of
your itemized tuition and fees invoice in order to process documents to apply those funds to your
account. Notify Deb at least one semester in advance of completing your MPH. You must be
registered either through the Medical School or because you’re in a degree-seeking program in order to
ensure you malpractice liability coverage and other student-related benefits.

LATE FEES
Refer to Pediatric Program Manual at:
http://www.pedsres.umn.edu/current/programmanual/services/fees/home.html

ADDITIONAL COURSES
Individuals wishing to take additional courses for credit should contact their Fellowship Coordinator AT
LEAST TWO (2) MONTHS prior to the beginning of the academic semester. Permission in writing
from the Fellowship Program Director is required to registe r for additional courses. There may be an
additional cost to the fellow for registering for additional courses for regular day school and certain
day/night courses. The Department of Pediatrics does not cover the cost for these courses. Refer to
“Tuition & Fees,” if you are pursuing a MPH degree.

CAMPUS MAIL
Any personal or professional mail, journals, etc., must be forwarded to your home address. University-
related mail addressed to fellows is available in each fellow's postal box located in Suite 353 at 717
Delaware St SE (3rd floor west); outside Room 361. The mailboxes are adjacent to the row of cubbies
shared by the fellows in the Divisions of Adolescent Health and Medicine & Academic General
Pediatric.




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




CAREER SEARCH RESOURCES
To assist fellows with their post- fellowship career search, some of the Professional Development
Seminars (held for Interdisciplinary Fellowship Training) held each year cover topics such as “Creating
a Professional CV,” “Writing an Effective Cover Letter,” “Interviewing for a Job, ” and “Negotiating a
Contract.” Training faculty is available for questions and advice, as needed, beginning with Dr Daniel P.
Kohen, Developmental-Behavioral Pediatrics Fellowship Director.

E-MAIL
Refer to Pediatric Program Manual at:
http://www.med.umn.edu/peds/pedsres/current/programmanual/services/email/home.html

HIPAA TRAINING
Refer to Pediatric Program Manual at:
http://www.med.umn.edu/peds/pedsres/current/programmanual/services/hipaa/home.html

PAGERS
University alphanumeric pagers are required at all times (the only exceptions are during a leave of
absence or vacation). You will be assigned one pager number to be used throughout your fellowship.
Pagers are available through your Fellowship Program Coordinator. Should you lose your pager, a
temporary or permanent replacement can be obtained at the University of Minnesota Medical Center
(UMMC/UMACH) Information Desk. Notify your Fellowship Coordinator immediately of the loss.
Please note: Once you locate your lost pager, please return the replacement to Communications and
notify the Coordinator, or you may be billed by the department. Pagers are the property of Fairview and
must be returned no later than 30 days after leaving/completing the program. If you lose your pager, do
not return your pager or if your pager becomes damaged beyond repair, you may be charged the
replacement pager fee.

For those residents entering a UMN fellowship, your residency pager number can be transferred into
fellowship by having your Fellowship Program Coordinator contact the Education Manager at
elgray@umn.edu.

RESIDENT ASSISTANCE PROGRAM (RAP)
Refer to Pediatric Program Manual at:
http://www.med.umn.edu/peds/pedsres/current/programmanual/services/rap/home.html

SECTION 2 - BENEFITS
(Please refer to Institution Policy Manual at
http://www.med.umn.edu/gme/residents/instpolicyman/home.html for Medical School Policies on the
following: Boynton Health Services; Employee Health Services; Exercise Room at UMACH-F; FICA;
Dental Insurance; Health Insurance; Life Insurance; Voluntary Life Insurance; Long -Term Disability;
Short-Term Disability; Insurance Coverage Changes; Bereavement Leave; Family Medical Leave Act
(FMLA); Holidays; Medical Leave; Military Leave; Parental Leave; Personal Leave; Professional
Leave; Vacation/Sick Leave; Witness/Jury Duty; Effect of Leave for Satisfying Completion of Program;
Loan Deferment; Minnesota Medical Association Membership; Minnesota Medical Foundation




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




Emergency Loan Program; Pre-Tax Flexible Spending Accounts; Professional Liability Insurance;
Stipends; Veterans Certification for Education Benefits; Workers’ Compensation Benefits).

EDUCATIONAL EXPENSE ALLOWANCE
You have funding to use toward the cost of attending at least one (1) professional meeting per year. A
University of Minnesota Purchasing Card (P-card) can be used to directly pay your airline tickets and
your conference registration, thus eliminating out-of-pocket expense for you. Once you have decided
what conference/meeting you wish to attend, please contact Jen Beckman (612-626-6129 or
beck0652@umn.edu) to set up a meeting with her and learn what information you need to bring with
you to that meeting. Payments and reimbursements under this allowance need to be made in accordance
with University business practices. Deb Seyfer can prepare a letter confirming you are in a fellowship
training program to accompany your registration, if required by the conference planners. Please contact
Deb Seyfer at 612-626-2953 or dappe001@umn.edu with any questions you have about pre- and/or
post-travel procedures.

INSURANCE
Contact Deb Slavin at 612-626-6910/ slavi002@umn.edu if your question involves any payroll
implications or contact Office of Student Benefits at 612-624-0627 or umshbo@umn.edu if you have
strictly a benefit question. When in doubt, contact Deb.

Refer to Pediatric Program Manual for insurance information at:
http://www.med.umn.edu/peds/pedsres/current/programmanual/benefits/insurance/home.html

Health and Dental Insurance Coverage

Professional Liability Insurance

Life Insurance

Voluntary Life Insurance

Long-Term Disability Insurance

Short-Term Disability Insurance

Insurance Coverage Changes (refer also to the Pediatric Program Manual)

LAUNDRY SERVICES
Developmental- Behavioral Pediatrics fellows are not required to have/wear a lab coat. If you choose to
have one, laundry is the responsibility of the individual fellow.




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




LEAVE POLICIES
POLICY ON EFFECT OF LEAVE FOR SATISFYING COMPLETION OF PROGRAM
All fellows should first review the University of Minnesota Medical School’s Institution Policy Manual
for the sections discussing LOAs and leaves. This manual is at:
http://www.med.umn.edu/gme/residents/instpolicyman/home.html.

As required by the American Board of Pediatrics, all fellows must complete three years (36 months) of
pediatric training. Of these, 33 months must be spent in completing training requirements. This leaves
one month for each year of training to be applied to vacation, sick time, parental leave, and other
absences. When accumulated absences from training exceed this three month allotment, training may be
extended to satisfy ABP requirements.

If you have questions regarding training time requirements, please review these with your Fellowship
Program Director.

Vacation
Standard paid vacation time for Year 1 for each fellow is three (3) weeks. Standard paid vacation time
for Years 2 and 3 for each fellow is four (4) weeks. Vacation and other planned absences (conferences,
Board review courses, interviewing, etc.) should be arranged at least 90 days in advance with Dr Nimi
Singh, the Fellowship Director.

Holidays
Fellowship programs follow the Pediatric Residency Program holiday schedule and policy located at:
http://www.med.umn.edu/peds/pedsres/current/programmanual/benefits/leave/holidays/home.html.
University of Minnesota, University of Minnesota Physicians, or other organizations’ official holidays
are not program holidays.

Interviewing Time
A fellow may take up to three calendar days of non-vacation time to interview for a job. These dates
must be scheduled with the program in advance and minimize program interruption.

Professional/Academic Leave
A fellow may take up to four calendar days of non-vacation time to attend professional meetings in each
year of fellowship. The fellow must submit a request indicating (a) the conference objectives and
essentials and the ways in which the meeting fits into the fellow's overall training goals, and (b) plans
for appropriate coverage of patient care responsibilities. The travel request must be approved by the
Fellowship Director at least 60 days in advance of the conference.

Parental: Maternal/Paternal/Partner Leave
The typical date/pay configuration in Pediatrics for parental leave is as follows:
    Maternity Leave (LOA Form MUST be completed and given to Fellowship Coordinator,
       Education Manager (elgray@umn.edu), and Payroll (slavi002@umn.edu) prior to leave):




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




           o Typical birth-Two (2) weeks of paid time that does not extend training and four (4) weeks
               of short-term disability that extends training. Any time on LOA after these dates is
               unpaid and extends training.
           o Cesarean-section- Two (2) weeks of paid time that does not extend training and six (6)
               weeks of short-term disability that extends training. Any time on LOA after these dates is
               unpaid and extends training.
      Paternal Leave: Two (2) weeks of paid time that does not extend training. Any time on LOA
       after these dates is unpaid and extends training.
      Partner Leave: Two (2) weeks of paid time that does not extend training. Any time on LOA after
       these dates is unpaid and extends training.

Sick Leave
An illness resulting in an absence from a rotation must be communicated to the Fellowship Program
Director to assure adequate coverage. Any illness resulting in an absence in excess of forty-eight (48)
hours requires a physician’s letter describing the medical condition, reason for absence, and anticipated
length of the illness. This policy applies only to personal illness. These absences must be documented
with a physician's letter. This time can extend training.

Medical Leave
For a continuous absence due to personal illness or disability while under the care of a physician, see the
disability policies outlined in Institution Policy Manual at
http://www.med.umn.edu/gme/residents/instpolicyman/home.html. Written confirmation by the fellow's
physician of the need for absence from the training program is required.

When it appears that a major illness will result in a continuous absence from service, it is essential that
the trainee communicate with their Fellowship Director, Fellowship Coordinator, the Department of
Pediatrics’ Payroll Office, and the Office of Student Benefits.

Personal Leave of Absence
Only under UNUSUAL circumstances, such as a personal or family emergency, will a Personal LOA be
considered. Such an LOA will be subject to the general conditions noted above. All personal time taken
must be made up.

Requests for a personal LOA should be considered carefully as they create scheduling stress in the
program and may extend your training. When time away due to LOA is made up at the end of residency
training, the additional rotation(s) will conform to the requirements of the American Board of Pediatrics
and to program requirements. These rotations and sites may not be the same rotations or sites that were
changed to accommodate the LOA. Added rotations are assigned to meet individual training needs and
program requirements. Individual preferences may be accommodated when possible.

All LOAs must be discussed with your Fellowship Director and approved in writing at least three (3)
months in advance of the start of the LOA. Exceptions may be made if the request falls within the
definition of the Family Medical Leave Act (FMLA).




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




The insurance benefits noted previously in the Institution Manual may be continued at your own
expense during a personal LOA. Please consult with the payroll office to arrange extended coverage:
Deb Slavin (612) 626-6910.

MEAL ALLOTMENT
The policy for meals at UMACH is outlined at:
http://www.med.umn.edu/peds/pedsres/current/programmanual/benefits/meals/home.html. If you qualify
for a meal allotment under this policy, contact your coordinator if you do not receive a meal card.
Developmental- Behavioral Pediatrics fellows do not receive a meal allotment.

PARKING
There is no contract or University-paid parking for Developmental- Behavioral Pediatrics fellows. Each
fellow is responsible for his/her parking expenses.

PHOTOCOPYING PRIVILEGES
A copy machine is located in Room 379 at the Division offices, 717 Delaware St SE (3rd floor west).
There is a sign-on code specific to each source of funds in the Divisions, including grant(s) supporting
fellowship activities. Copying is available at no charge for fellows’ teaching efforts (i.e., teaching
residents on the Developmental-Behavioral Pediatrics rotation; teaching at Interdisciplinary Fellowship
seminars). There is no copy allowance for personal or coursework copying. PDFs can be created {at no
charge} on the copier, for any/all purposes. Arrange for this through Deb Seyfer (6-2953 or
dappe001@umn.edu ).

Developmental- Behavioral Pediatrics rotation and/or Interdisciplinary Fellowship Training: bring your
copying to Deb Seyfer


SCRUB SUITS, LABCOATS, AND ID BADGES
A UMN AHC ID badge is provided in addition to any hospital badges you will receive. Badges must be
worn for clear identification. If your AHC badge breaks or is lost, the department will provide a replace-
ment. Other lost/broken badges are replaced by the institution (i.e., contact UMMC/UMACH security
desk for Fairview badges). Fellows should contact their fellowship coordinator to arrange for their
badges.

Professional attire is expected for clinical care and is the responsibility of the fellow. Developmental-
Behavioral Pediatrics fellows do not need or receive scrub suits or lab coats.

STIPENDS
Stipend rates and policies are at: http://www.med.umn.edu/gme/residents/stipendinfo/home.html

PAYCHECKS/DIRECT DEPOSIT
Refer to Pediatric Program Manual at:
http://www.med.umn.edu/peds/pedsres/current/programmanual/benefits/pay/home.html




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




TAX INFORMATION
Other than providing the standard W-4 deduction claim forms, the Department of Pediatrics does not
provide information or advice on tax matters.

WORKER’S COMPENSATION POLICY AND PROCEDURES
Refer to Institution Policy Manual at:
http://www.med.umn.edu/gme/residents/instpolicyman/beneworkerscomp/home.html

SECTION 3 - Institution Responsibilities
(Please refer to Institution Policy Manual at
http://www.med.umn.edu/gme/residents/instpolicyman/home.html for Medical School Policies on the
following: ACGME Resident Survey Requirements; ACGME Site Visit Preparation Services; Master
Affiliation Agreements or Institution Affiliation Agreements; Program Letters of Agreement;
Confirmation of Receipt of Program Policy Manuals; Designated Institution Official Designee Policy;
Duty Hour Monitoring at the Institution Level Policy and Procedure; Experimentation and Innovation
Policy; Funding; GME Competency Teaching Resources and Core Curriculum; Graduate Medical
Education Committee (GMEC) Responsibilities; Graduate Medical Education Committee Resident
Leadership Council Responsibilities; Institution and Program Requirements; Internal Review Process;
International Medical Graduates Policy; New Program Process; Orientation; Visa Sponsorship Policy).

SECTION 4 - DISCIPLINARY AND GRIEVANCE PROCEDURES
(Please refer to Institution Policy Manual at
http://www.med.umn.edu/gme/residents/instpolicyman/home.html for Medical School Policies on the
following: Discipline/Dismissal/Nonrenewal; Conflict Resolution Process for Student Academic
Complaints; Academic Incivility Policy and Procedure; University Senate on Sexual Harassment
Policy; Sexual Harassment and Discrimination Reporting; Sexual Assault Victim’s Rights Policy;
Dispute Resolution Policy).

GRIEVANCE PROCEDURES AND DUE PROCESS
The following is an outline of the general procedures and process for the resolution of grievances which
may arise within the fellowship program. Detail and clarification must be added as the various elements
of these proposals are accepted or rejected or replaced with alternatives. These guidelines or policies are
confined to the process within the Department of Pediatrics with the assumption that appeal of the final
action or decision coming from the intradepartmental process will remain a viable option once the
departmental grievance process has been completed.

A.     Principles
       1.      Definition of the legitimate areas of disagreement to be covered by these procedures.
       2.      Provision of ascending levels of recourse with potential for final reso lution of the conflict
               at each of these levels without prejudice to any rights of the involved individuals.
       3.      Adherence to the principles of due process, academic freedom and fairness.
       4.      Procedures to be readily available and expeditiously executed.
       5.      Inclusion of a system of advocacy.
       6.      Process to be fully documented.




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




B.     Grievance Committee for the Pediatric Education Programs
       1.     The Department of Pediatrics Residency Review Committee (RRC) will fulfill this role.
       2.     All actions of this committee are considered advisory to the Fellowship Program Director
              and the Head of the Department of Pediatrics.
       3.     All recommendations of this committee are by a simple majority vote with a quo rum
              present. A quorum consists of one-half of all the named members of the committee, plus
              one.

C.     Areas of Potential Grievance Covered by these Guidelines
       The areas of possible grievance to be resolved by the following procedures will include, but not
       be limited to, the following:
       1.      Evaluation of fellow performance by the faculty.
       2.      Assignment or definition of fellow duties.
       3.      Interpretation and implementation of other policies and guidelines, such as those included
               in this document.
       4.      Fellow- fellow conflicts.
       5.      Fellow-chief resident conflicts.
       6.      Fellow-resident conflicts.
       7.      Fellow- faculty conflicts.

D.     Potential Parties to the Process
       1.      Principals in the complaint.
       2.      Mentors, as advisors and advocates.
       3.      Grievance committee.
       4.      Department Head and/or a designee.

E.     Grievance Resolution Process
       As defined here, resolution will be considered an outcome deemed acceptable to the principals to
       the complaint. When resolution is reached, no further steps in the process will be taken and the
       matter will be considered closed. This policy assumes that any single principal to the grievance
       retains the right to carry the process forward by denial of resolution, and to appeal the
       intradepartmental decisions to extra-departmental grievance procedures.

Steps in the Process:
            1. Review of complaint with mentor or other ad hoc advisor. Outcome: resolved OR taken
                to step 2
            2. Informal discussion with other persons deemed appropriate by parties to the complaint.
                Outcome: resolved OR taken to step 3
            3. Formulation of a formal written complaint.
            4. Forwarding of complaint to the grievance committee, with copies to principals to the
                complaint and to the Head of the Department.
            5. Committee review of the complaint with consultation and written minutes, but without
                tape recording. Outcome: resolved with report to the Head of the Department OR taken
                to step 6




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




           6. Department Head reviews the grievance committee actions and rec ommendations and
              then advises the parties to the complaint of his decision as to the dispensation of the
              complaint action. Outcome: resolved OR taken to step 7
           7. Appeal to the Medical School and the appropriate extra-departmental grievance process



HOUSE STAFF SUBSTANCE USE/ABUSE POLICY
It is the policy of the University of Minnesota that personnel will be free of controlled substances.
Chemical abuse affects the health, safety and well-being of all members of the University community
and restricts the ability of the University to carry out its mission. Similarly, the Department of
Pediatrics recognizes that chemical/substance abuse or dependency may adversely affect the physic ian-
in-training’s ability to perform efficiently, effectively and in a professional manner. The department
believes that early detection and intervention in these cases constitutes the best means for dealing with
this social problem and creates the best environment for providing improved patient care. Accordingly,
the following policy has been adopted.

           A. No fellow shall report for assigned duties under the influence of alcohol, marijuana,
              controlled substances, or other drugs including those prescribed by a physician which
              affect his/her alertness, coordination, reaction, response, judgment, decision- making
              abilities, or adversely impact his/her ability to properly care for patients.
           B. Engaging in the use, sale, possession, distribution, dispensation, transfer or manufacture
              of illegal drugs or controlled substances may have a negative impact on fellow’s ability to
              perform his/her duties; therefore, no fellow shall use, sell, possess, distribute, dispense,
              transfer or manufacture any illegal drug, including marijuana, nor any prescription drug
              (except as medically prescribed and directed) during working hours, while on rotation at
              any hospital or institution participating in the training program.
           C. Any violation of this policy may subject the fellow to discipline, including, but not
              limited to, suspension and/or termination.
           D. When there is reasonable cause to believe that a fellow may be using, selling, possessing,
              distributing, dispensing, transferring, or manufacturing any illegal drug, controlled
              substance, or alcohol, the fellow may be required to undergo medical evaluation and
              assessment. The fellow’s ability to continue participation in the program will be
              determined by their Fellowship Program Director in consultation with attending faculty,
              Department of Pediatrics Residency Review Committee, and/or the Department Head.
              Actions may include, but are not limited to, recommendation for treatment and return to
              duty, suspension from duty with pay, suspension from duty without pay, and/or
              termination.
           E. Depending upon the circumstances, the department may notify appropriate law
              enforcement agencies and/or medical licensing boards of any violation of this policy.
           F. Fellows who are convicted of a criminal drug statute violation (including DWI, boating
              tickets, etc.) are required to inform their Fellowship Program Director, Department of
              Pediatrics Residency Review Committee, and/or the Department Head of the conviction
              (in writing) within five (5) calendar days thereof.
           G. Other fellows who have reasonable cause to believe that a colleague is using a substance
              which adversely impacts on the fellow’s performance in the training program must report
              the factual basis for their concerns to their Fellowship Program Director.




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




          H. If a fellow is taking a medically authorized substance which may impair his or her job
             performance, the fellow must notify his or her supervising attending faculty or the
             Fellowship Program Director of his or her temporary inability to perform assigned duties.
          I. The policy of the American Board of Pediatrics maintains that physicians who have a
             history of chemical dependency, as reported to the American Board of Pediatrics, and
             who submit documentation acceptable to the American Board of Pediatrics that their
             disease is known to be under control, can apply for and take the certifying examination.
             Candidates who have a current problem of chemical dependency, as reported to the
             American Board of Pediatrics, will not be issued a certificate upon completion of all
             requirements for certification unless they submit documentation that their disease is
             known to be under control for five (5) years from the time of the most recent occurrence
             of the disease.
          J. Fellows are encouraged to seek assistance in addressing any problems they might have
             related to alcohol or substance abuse.
          K. Fellows must be aware that there are significant criminal penalties, under state and
             federal law, for the unlawful possession or distribution of alcohol and illicit drugs.
             Penalties include prison terms, property forfeiture, and fines.

SECTION 5 - GENERAL POLICIES AND PROCEDURES
(Please refer to Institution Policy Manual at
http://www.med.umn.edu/gme/residents/instpolicyman/home.html for Medical School Policies on the
following: Academic Health Center (AHC) Student Background Study Policy; Background Study Policy
and Procedure; Applicant Privacy Policy; Appointment Letter Policy and Procedure; Blood Borne
Pathogen Diseases Policy; Certificate of Completion Policy; Classification and Appointment Policy;
Compact for Teaching and Learning; Disability Policy; Disaster Planning Policy and Procedure;
Documentation Requirements Policy; Documentation Retention Requirements for FICA Purposes
Policy; Dress Code Policy; Duty Hours/On-Call Schedules; Duty Hours Policy; Duty
Hours/Prioritization of On-Call Room Assignments; ECFMG/J1 Visa Holders: Documentation
Required for FMLA; Effective Date for Stipends and Benefits Policy; Eligibility and Selection Policy;
Essential Capacities for Matriculation, Promotion and Graduation for U of M GME Programs;
Evaluation Policy; Health Insurance Portability and Accountability Act; Immunizations and
Vaccinations; Immunizations: Hepatitis B Declination Form; Impaired Resident/Fellow Policy and
Procedure; Licensure Policy: Life Support Certification Policy; Moonlighting Policy; National Provider
Identification (NPI) Policy and Procedure; Nepotism Policy; NRMP Fees Policy; Observer Policy; Post
Call Cab Voucher Policy (UMACH-F; HCMC); Registered Same Sex Domestic Partner Policy; Release
of Contact Information Policy; Residency and Fellowship Agreement Policy; Residency Management
Suite (RMS): Updating and Approving Assignments and Hours in the Duty Hours Module of RMS;
Restrictive Covenants; RMS Information Maintenance for Participating Hospitals; Standing and
Promotion Policy; Stipend Level Policy; Stipend Funding from External Organizations Policy;
Supervision Policy; Training Program and/or Institution Closure or Reduction Policy; Transitional
Year Policy; USMLE Step 3 Policy; Vendor Policy; Verification of Training and Summary for
Credentialing Policy; Voluntary Life Insurance Procedure; Without Salary Appointment Policy ).




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




SUBSPECIALTY TRAINING REQUIREMENTS FOR FELLOWS
Academic Expectations for Pediatric Fellows
The Department has identified a core list of academic expectations for all pediatric fellows in order to
support our mission. This list includes, but is not limited to, completion of ABP requirements,
development of an individualized learning plan (ILP), Scholarship Oversight Committee meeting
frequency, identification of an academic mentor, completion of Core Curriculum series, attendance at
Pediatric Research, Education, and Scholarship Symposium (PRESS), and presentation of scholarly work.
The current list of Academic Expectations for Fellows is located at:
http://www.med.umn.edu/peds/education/fellowships/current/home.html.

Core Curriculum
Each fellow in the Pediatrics department is responsible for completing a core curriculum that meets
ACGME and ABP guidelines for their individual specialty in addition to or in support of topics
determined by the Fellowship Director Committee and/or Fellowship Oversight Committee as critical
for academic development at the University of Minnesota.

There is a two-year rotation of core topics within the broad categories of ACADEMIC
DEVELOPMENT, CLINICAL EXCELLENCE, and RESEARCH EXPERTISE, organized for
presentation over the two years as a total of six “core” days. Attendance by all fellows is required. Each
core day is scheduled 1:30p-4:30p (three hours), including three to four 45- minute presentations within
one of the broad categories listed above. The core days are scheduled to occur in the months of October,
January and March.

The additional core curriculum categories of BIOSTATISTICS, GRANT WRITING, TEACHING
DEVELOPMENT, and RISK MANAGEMENT can be met through a variety of existing University of
Minnesota, professional association (ie, PAS workshops/seminars), or other clinical organization
resources. A schedule will be posted on a site yet to be determined outlining dates and times to attend
these opportunities. It will be up to the individual fellow and program director to determine the best
option available in each category for the fellow to complete, based on the specific educational
goals/interests of the fellow, as well as divisional financial resources (as some options will require a fee
or tuition), in order to meet that specific requirement.

All first- year fellows are required to complete the University of Minnesota orientation that includes a
number of ACGME-required core topics (sleep medicine, drugs/alcohol impairment, work hour
restrictions, ethics in medicine). A third-year fellow core day will be held each year, focused on how to
approach the job search, interviewing, CV preparation, contract negotiation, and ABP MOC/QA/QI.
Annual attendance at PRESS is expected of all fellows as a component of their core curric ulum.

A Core Curriculum Tracking Document is a tool designed to allow flexibility for each individual fellow
to meet these requirements in order to limit redundancy, enhance camaraderie, promote attendance and
self learning, and take advantage of existing programs and faculty expertise in specific areas. The Core
Curriculum Tracking Document is to be completed at the beginning of each trainee’s fellowship and
reviewed during the fellow/program director semi-annual meeting. Specific goals and coursework are to
be adjusted on a yearly basis to reflect changes in each individual’s schedule, interests, and progress.




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




Fellows Core Curriculum Schedule 2010-2011

10/27/1010          1:30-2:30 pm        Family Conference: Tom George, Karla Hemaseth, Social
Mayo 3-125                              Worker Rachel, Chaplain Chuck Ceronsky
                    2:30-3:30 pm        Professionalism / Ethics: John Andrews, John Song
                    3:30-4:30 pm        How to Do a Consult: Bryce Binstadt

1/26/2011           1:30-2:30 pm        Feedback: John Andrews
Location TBD;
potentially Mayo
3-125
                    2:30-3:30 pm        Academic Mentoring: Toni Moran
                    3:30-4:30 pm        Fellows as Teachers: James Nixon

3/09/2011           1:30-2:30 pm        Poster Presentations: Mark Schleiss
Location TBD;
potentially Mayo
3-125
                    2:30-3:30 pm        Intro to CTSI: Mark Schleiss
                    3:30-4:30 pm        IRB Clinical Study Design: Logan Spector

April/May 2011      Approximately       PRESS (Pediatric Research Education and Scholarship
(date TBD)          11:45 am –          Symposium)
Location probably   5:00 pm
Radisson on UM
campus



Scholarly Activities
In addition to participating in a core curriculum in scholarly activities, all fellows will be expected to
engage in projects in which they develop hypotheses or in projects of substantive scholarly exploration
and analysis that require critical thinking. Areas in which scholarly activity may be pursued include, but
are not limited to: basic, clinical, or translational biomedicine; health services; quality improvement;
bioethics; education; and public policy. In addition to biomedical research, examples of acceptable
activities might include a critical meta-analysis of the literature, a systematic review of clinical practice,
a critical analysis of public policy, or a curriculum development project with an assessment component.

Work Product of Scholarly Activity
Involvement in scholarly activities must result in the generation of a specific written "work product" as
outlined by the ABP (www.abp.org). Examples of include, but are not limited to:
     A peer-reviewed publication in which a fellow played a substantial role
     An in-depth manuscript describing a completed project
     A thesis or dissertation written in connection with the pursuit of an advanced degree
     An extramural grant application that has either been accepted or favorably reviewed
     A progress report for projects of exceptional complexity, such as a multi- year clinical trial




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




The fellow’s Scholarship Oversight Committee (SOC) is instrumental in guiding the fellow’s activity
towards an acceptable product. The SOC will be arranged by each fellow in collaboration with the
program director. In addition to the work of the SOC, the department will provide all subspecialty
fellows with the opportunity to participate in a departmental research, education, and scholarship forum
to present their work product and receive feedback from department faculty.

Scholarship Oversight Committee (SOC)
The SOC, in conjunction with the trainee, the mentor, and the program director will determine whether a
specific activity is appropriate to meet the ABP guidelines for scholarly activities (www.abp.org). These
activities require active participation by the fellow and must be mentored. The mentor(s) will be
responsible for providing the continuous ongoing feedback essential to the trainee’s development.

Review of scholarly activity and the written work product will occur at the local level with each fellow
having a SOC responsible for overseeing and assessing the progress of each fellow and verifying for the
ABP that the requirement has been met. The SOC must consist of three or more individuals, at least one
of whom is based outside the subspecialty discipline; the fellowship program director may serve as a
trainee’s mentor and participate in the activities of the oversight committee, but should not be a standing
(i.e. voting) member. Particular emphasis will be placed on encouraging identification of committee
members whose professional and research responsibilities encompass elements of the trainee’s scholarly
interest, but who do not necessarily have a primary appointment in the Department of Pediatrics.
Examples of such individuals include faculty in clinical departments in the University of Minnesota
Academic Health Center (AHC), faculty in basic science departments, or faculty in the Schools of
Public Health or Education.

This committee will:
         1. Determine whether a specific activity is appropriate to meet the ABP guidelines for
              scholarly activity.
         2. Provide guidance in charting a course of preparation beyond the core fellowship
              curriculum to ensure successful completion of the project.
         3. Evaluate the fellow's progress as related to scholarly activity.
         4. Meet with the fellow early in the training period (within 6 months of initiation of
              fellowship training) and regularly thereafter.
         5. Require the fellow to present/defend the project related to his/her scholarly activity.
         6. Advise the program director on the fellow's progress and assess whether the fellow has
              satisfactorily met the guidelines associated with the requirement for active participation
              in scholarly activities.

The fellow, in conjunction with the fellowship director or designee and research mentor, should identify
the direction for the scholarly activity. At the first SOC meeting, the purpose will be to hear the general
path the fellow has chosen, to help further outline the path, and determine the specific steps for the
fellow to meet the outlined path. The SOC should meet again within 4-6 months of the first meeting and
at least semi- annually thereafter to further update and guide the fellow on developing their scholarly
path.

A written report by the chair of each trainee's SOC should be completed twice a year and forwarded to
the fellowship program director. The Department Education Office will provide the subspecialty training




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




programs with standard forms for documenting each SOC meeting. The fellowship director and the head
of the fellow's SOC are expected to monitor whether additional SOC meetings are necessary for fellows
who need more help or may be changing their scholarly activity.

The final responsibility of the SOC is to review and approve the final scholarly “work product” of the
applicant prior to submission to the ABP.

A list of potential SOC members and their research interests are available under “Fellowship
Administration Intranet” at:
http://www.med.umn.edu/peds/education/fellowships/home.html. You will need to log in to the Intranet
with your x500 and password. Fellows are encouraged to recruit their own SOC members with guidance
from their program director.

External Oversight
A program’s ability to provide a satisfactory scholarly experience for all trainees will be evaluated
periodically, as described below.
             The Pediatric Residency Review Committee (RRC) of the ACGME reviews the training
                program’s structure as it relates to the ACGME clinical, administrative, and scholarly
                activity requirements.
             Periodic peer review of the quality of the training environment related to scholarly
                activity, in addition to that undertaken by the RRC, occurs. Currently, the Department of
                Pediatrics’ Fellowship Oversight Committee (FOC) serves in this peer review role.

Responsibilities of the Training Program Director
In addition to meeting the requirements of the ACGME related to the six general competencies, the
responsibilities of the training program director shall include the creation of a core curriculum in
scholarly activities, the identification of a mentor, the creation of the Scholarship Oversight Committee
responsible for overseeing and assessing the progress of each trainee, and providing verification to the
ABP of the successful completion of training. Additional duties are as assigned by the Department of
Pediatrics’ Department Head and the University of Minnesota Medical School.

It is the responsibility of the training director to review the SOC documentation and clarify the
responsibilities and outcomes for each fellow. The SOC and the Fellowship Program Director are both
accountable for scholarly progress of individual fellows and will share their recommendations with the
Department Chair.

Verification of Scholarly Activity
Upon completion of training, the ABP will require:
            Verification from the training program director that the clinical and scholarly skills
              requirements have been met
            A comprehensive document (i.e. personal statement), written by the fellow, describing
              the scholarly activity that includes a description of his/her role in each aspect of the
              activity and how the scholarly activity relates to the trainee’s own career development
              plan
            The actual “work product” of the scholarly activity as described above




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




              Signature of the fellow, program director, and members of the Scholarship Oversight
               Committee on both the personal statement and work product of the fellow as described
               above

The fellow will need to produce the work product and personal statement, as well as obtain approval
from the SOC to be eligible to sit for the Subspecialty Board Examination. The decision about the
adequacy of the work product is the responsibility of the SOC and the program director.

Fellowship Program Directors are evaluated on these responsibilities annually as part of their annual
faculty performance review.


CURRICULUM – Developmental-Behavioral Pediatrics Fellowship
The Curriculum By Year
     Year 1 is focused on the building of clinical skills in developmental-behavioral pediatrics, with half
of the fellows’ time focused on clinical experiences based at two or more of the four core clinical sites.
These experiences are augmented by completion of a yearlong Child Development Seminar, a bi- weekly
Family Systems Seminar, a bi- weekly Cultural Competence training sequence, and six credit hours per
semester toward a Master’s in Public Health (MPH) degree in Maternal and Child Health. The Year 1
curriculum includes research guidance, writing for publication, public speaking, preparing testimony,
grantwriting, and advocacy. These leadership components are presented as two themes: 1) research and
its policy and practice, and 2) cultural competence.
     Research and Its Policy and Practice Applications: Over recent years, programs of the University’s
MCHB Training Consortium have piloted an innovative curriculum that not only trains fellows in the
unique skills of research and advocacy but then also brings them together to demonstrate the practice of
translating research into its policy applications. This is one of four interconnected themes that has been
implemented and is being evaluated over a five-year period. Steps toward reaching this goal are:
     Step I: Observe Graduating Fellows: Each Developmental-Behavioral Pediatrics fellow has their
own individually-developed Scholarly Oversight Committee to serve as a mentoring and monitoring
guide for the Fellow during the evolution of their research and other scholarly activities. Fellowship
program Orientation begins the day the preceding year’s graduating fellows (from Developmental-
Behavioral Pediatrics and the other three fellowship programs in the Division) give their concluding
scientific presentations. Incoming fellows observe the methodologic sophistication and array of skills
graduating fellows have acquired in undertaking and presenting research - from hypothesis to skills in
scientific platform presentation. Senior fellows’ presentatio ns clearly set a high bar for incoming
fellows.
     Step II: Selecting a Data Set: In the first months of fellowship, faculty present data sets on which
they are working. From these options, fellows may select their research focus. Current datasets available
to fellows include: an office-based violence prevention program for middle school children; child and
youth development data from an MCHB- funded epidemiologic survey of exercise and eating behaviors;
an assessment of self- hypnosis for chronic headaches in childhood; and the 1998 Minnesota Student
Survey of 6th and 9th graders. This is a model pioneered in recent years in the LEAH and Center for
Adolescent Nursing and is expanding to other Minnesota-based MCHB Programs. Faculty are obligated
to work closely and meet regularly with fellows who select their data set. Alternatively, fellows may
develop a research focus creating their own unique data set.




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




     Step III: An Integrated Curriculum : The research and advocacy curriculum is structured and
integrated throughout the year to ensure that key landmarks are achieved on a pre-established schedule.
     Step IV: Final Products: By the end of the fellowship, all fellows will have completed a set of
products resulting from this mentored research, advocacy and communications training: 1) a manuscript
submitted to a peer reviewed journal; 2) a high quality scientific presentation based on research findings;
3) translation of research findings into written and verbal testimony presented to a mock hearing panel
(e.g., legislative committee, school board); 4) a draft of a grant application for program implementation
and/or research based on preliminary data; 5) an edited videotape of clinical encounter (interview and/or
therapy session) for utilization in ongoing training in developmental-behavioral pediatrics for students,
residents, and fellows.
2. Cultural Competence: Training in cultural competence is one of the four crosscutting themes that
integrate the Developmental-Behavioral Pediatrics curriculum. By culture we include individuals and
groups defined by race, ethnicity, language, geographic origins, and current residence, religious/spiritual
beliefs, sexual orientation, and socioeconomic status. Thus, cultural competence is both a knowledge
and skill set that allows the health professional to meet the individual, family, and/or community health
and related needs across diverse populations of children and youth. This competence requires the health
professional to understand him/herself as one who has a cultural heritage and a set of prior experiences
that among other things include assumptions and biases about other groups. Such self-awareness is
necessary but not sufficient to work effectively with diverse populations of children and families. The
multi- faceted training of fellows at the University of Minnesota’s Developmental- Behavioral Pediatrics
Program provides the necessary skills and insights for cultural competence.
     Step I: Orientation: During orientation a panel of parents who have children with a range of
behavioral and developmental problems begins to raise issues related to cultural differences among
diverse groups. Secondly, an interdisciplinary training session allows incoming fellows to explore
assumptions and biases they have about other disciplines (e.g., “All psychologists have emotional hang-
ups.” “Nurses are meek.” “Physicians are arrogant.”).
     Step II: Reflective Practice Conference: This conference uses senior fellows as well as faculty under
the guidance of Michele Strachan, MD, MPH. Dr. Strachan holds bi- monthly case conferences with all
Division fellows to reflect on the cultural dimensions of their clinical encounters, research experiences,
home and community visits. The seminar assists fellows in viewing culture from an assets-oriented
perspective in which culture is seen as a resource for health and healing, rather than as a barrier to be
overcome.
     Step III: Cultural Competence Workshops: Twice a year for the duration of training, fellows will
participate in a half-day workshop that utilizes adolescent actors as patient instructors in role-plays
dealing with cross-cultural issues. Under the direction of Mae Sylvester, MS, the Adolescent Actor’s
Program has been used over the past 10 years to train nurses as well as residents (pediatrics, internal
medicine, family practice and psychiatry). Using a culturally diverse adolescent acting troop (including
American Indian, Somali, African-American, Hmong, Latino, GLBT and European-American teens)
role-plays will become progressively more complex across the fellowship’s duration. Each role-play will
be videotaped and critiqued by the interviewer (the fellow), the interviewee (the adolescent actor) and
the faculty (Mae Sylvester, MS) as well as other faculty (Nimi Singh, MD, MPH, and Renée Sieving,
PhD, RN) and other fellows. Each fellow will retain her/his videotape, to monitor change and skill
acquisition over time.
     Additionally, fellows will participate in the Parents as Teachers (PAT) program developed more than
15 years ago as part of the Developmental Disabilities resident rotation coordinated through the Division
of General Pediatrics and Adolescent Health; for the past 8 years PAT has also been an integral




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




component of resident training during the Behavioral Pediatrics rotation (Year 1 of res idency). Through
Parents As Teachers, Developmental-Behavioral Pediatrics fellows (and residents) are matched with a
family whose child or children have a chronic illness and/or disability, and meet with the family on at
least two separate occasions outside of clinical environments with the specific goals of coming to know,
understand, and appreciate the families, and how they conduct their lives. within the context of their
illness and disabilities and own environment. Beyond visiting with families in their homes, fellows may
accompany children (with or without parents, or with or without a health aide/assistant) with disabilities
to school, to play, to occupational or physical therapy, to music lessons, or an adaptive physical
education class or game. A group of culturally diverse, and illness/disability diverse, parents of children
with chronic illness and disability volunteer to share their stories and teach fellows and other learners in
this unique learning experience.
     Step IV: Course Work: All fellows have the option of taking one of two courses: CPsy 8-322:
Culture and Development in the Institute of Child Development which explores the impact of race,
culture, poverty, and racism on the development and children and youth. The second, SW 5-052
Ecologies of Child Development within Communities of Color, explores the role of racism in our society,
its manifestations both de facto and de jure and the consequences for young people growing up as
minorities in society.

      The Developmental- Behavioral Pediatrics Fellowship in the Department of Pediatrics at the
University of Minnesota is a three- year ACGME-accredited training program. In addition to complying
with the common program requirements put forth by the Accreditation Council for Graduate Medical
Education for Developmental-Behavioral Pediatrics Fellowship Training Programs, our fellows
participate in a unique program of Interdisciplinary Fellowship Training. Developmental-Behavioral
Pediatrics fellows participate in this leadership training with physician-fellows from Adolescent
Medicine and Primary Care Academic General Pediatrics; non- medical fellows from the Healthy Youth
Development Prevention Research Center, the School or Nursing (post-doctoral fellows from the Center
for Adolescent Nursing), the School of Public Health (Division of Epidemiology and Community
Health, Section on Nutrition), and the School of Social Work.

A. Leadership Education in Developmental-Behavioral Pediatrics (LEDBP) Core Curriculum:
1.    Learning Modules
Trainees: DBP Fellows and 24 pediatric residents participate in this series of presentations of core topics
in developmental and behavioral pediatrics (DBP).
Purpose: The core learning modules are designed to expand the trainee's level of knowledge of normal
child development and related common behavioral challenges
Faculty: (LEDBP Core Faculty, Fellows as Peer and Resident Educators)
Goals:
a. Broaden trainees’ knowledge of normal child development and its relationship to understanding
    common DBP challenges for parents and children.
b. Expand the learners' knowledge, sensitivity to, and skill in the use of the therapeutic interview as a
    diagnostic and management strategy.
c. Increase competence in the recognition of a wide variety of DBP problems in children
d. Promote awareness and increase competence in the identification and management of DBP aspects
    of common primary care dilemmas.
e. Promote implementation of the Bright Futures: Guidelines for Health Supervision of Infants,
    Children, and Adolescents and in the Bright Futures Mental Health Initiative.




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




f. Appreciate interaction between parent expectations DBP variations and outcomes.
Training Content: Learners participate in presentation and discussion of 14 learning modules presented
during weekly 3-hour morning seminars. Seminars are co-taught by residents/faculty or
residents/LEDBP fellows. The Web-based format is case-oriented with teaching techniques including
didactic presentation, case reports, role-play, and review of videotape vignettes. The unique web-based
format provides for self-directed, interactive learning with current and regularly updated evidence-based
learning materials (journal articles, chapters, videotapes). Thus, each learning module includes a case(s)
pertinent pre-assigned readings, learning objectives, and trigger questions to guide thinking about
management approaches to cases presented. Additional learning resources including reference materials
and videotape resources.
Learning Modules include:
Disorders of Elimination: Enuresis                Depression
Disorders of Elimination: Encopresis              Tics & Tourette Disorder
Resistant Toilet Training                         School Refusal
Attention Deficit Hyperactivity Disorder          Family Transitions: Death, Grief, and Loss
Autism Spectrum Disorders                         Family Transitions: Divorce
Habit Disorders: Nail-biting, Thumb-              Interviewing Adolescents, School Age Children,
Sucking, Habit Cough                              Preschoolers
Self-InjuriousBehavior/Cultural Challenges Persistent Somatic Complaints- Abdominal Pain
2.    Core Knowledge-Child Development (Institute for Child Development (ICD), College of
Education)
Trainees: LEDBP Fellows and first-year graduate students in Child Psychology
Purpose: Provide a foundation in understanding normal child development
Goals & Training Content: This 3-semester sequence (4 credits) self-contained foundation courses is
offered through the ICD’s program of Graduate Study in Child Psychology. Beyond the content of the
coursework, LEDBP fellows will benefit from learning with graduate students from related but different
disciplines and perspectives.
Faculty: Faculty-ICD. Sequence includes: Child Psy 2301 - Introductory Child Psychology. Child Psy
4302 - Infancy; Child Psy 431 - Behavior and Emotional Problems; Child Psy 4313 - Disabilities and
Development; Child Psy 4329 - Biologic Foundations of Development; and Child Psy 4345 - Language
Development and Communication. Child Psy 4303 – Adolescent Psychology. Methods: lecture, group/
individual projects, and video presentations.
3.    Early Child Development - Practical Tools for Assessment and Management. This seminar meets
for three hours per week for 4-5 weeks.
Trainees: LEDBP fellows and Pediatric residents
Faculty: LEDBP Faculty, Pediatric Psychology faculty, UMN Child Care Center staff.
Purpose: Provide practical tools and strategies for identifying DBP problems and assisting parents to
cope, directly or through referral, in an early intervention model
Goals: Participants will learn how to use parent completed questionnaires to assess children's
development and adjustment, including parent concerns, child problems and strengths. Participants will
learn how to observe and assess children's development using development charts and tests; how to
make structured observations of children at play (UMN Child Care Center) and discuss these
observations in LEDBP Fellow facilitated conferences. They will learn to provide support and guidance
to parents regarding normative developmental issues and to facilitate referral for further evaluation (e.g.
by Pediatric Psychologists). With Pediatric Psychologists, they will learn review and follow-up of
assessment and evaluation of development, and how to provide support and guidance regarding major




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




developmental and/or behavioral disorders and disabilities. Learners will expand their knowledge about
community resources for parents, including schools' early childhood/family education (ECFE) and
special education program.
Training Content: Tools include Pediatric Symptom Checklist (Jellinek), PEDS (Glascoe), BASC, Ages
& Stages Questionnaires (ASQ).
4.    DC: 0-3R Workshop
Faculty: MN Department of Human Services / Wilcoxon & Rose
Trainees: LEDBP fellows, physicians, therapists, teachers
Purpose: Develop an understanding, working knowledge of DC: 0-3R & its practical application
5.    Introduction to Pediatric Clinical Hypnosis. This 3-day, 24-hour training and skill-building
workshop is offered annually preceding the annual meeting of the SDBP (October, 2008 meeting in
Cincinnati OH). Each fellow will attend at least once.
Faculty: National teaching faculty: Candace Erickson, MD (Columbia), Daniel P. Kohen, MD
(LEDBP), Leora Kuttner, PhD (U of British Columbia), Karen Olness, MD (Case Western Reserve U),
Jud Reaney, MD (LEDBP), Jim Warnke, ACSW (Princeton, NJ), Lonnie Zeltzer MD (UCLA),
Laurence I. Sugarman, MD (Univ. of Rochester [NY]), Melanie Gold, DO (Univ. of Pittsburgh),
Howard Hall, PhD., PsyD. (Case Western Reserve U.), Tim Culbert, MD (LEDBP).
Trainees: LEDBP, other DBP fellows; Pediatricians; Pediatric Psychologists; Peds Nurse Practitioners;
Child Life professionals; Pediatric Social Workers
Purpose: To provide foundational knowledge of hypnosis and its broad application in child health care;
and a supervised practicum of skill development in techniques of child hypnosis.
Objectives include explaining hypnosis to families; common misconceptions; being confident in
offering explanations for appropriate understanding and therapeutic application; and developing skills in
applying clinical hypnosis therapeutically.
6.    COR: Collaborative Office Rounds - Pediatrics and Child Psychiatry (COR I: 2 nd and 4th Monday
mornings; COR II: 2nd Tuesday evenings)
Trainees: Fellows from LEDBP, Child Psychiatry, Primary Care General Academic Pediatrics, and
LEAH; community pediatricians, UMN and community psychiatrists, UMN and community
psychologists and psychology interns, and UMN and community DB pediatricians.
Faculty: Child Psychiatry and Developmental- Behavioral Pediatrics Co-Moderators
Purpose/Training Content: COR, a joint venture of the UMN Department of Pediatrics-DBP and UMN
Department of Psychiatry-Division of Child & Adolescent Psychiatry, has met bi- weekly since
December, 1996, to foster increased understanding and knowledge of child biopsychosocial issues and
concerns amongst community pediatricians. Objectives include: (l) incorporate into comprehensive child
health care services a more thorough awareness and attention to the dbp aspects of pediatrics; (2)
increase confidence in ability to identify and help children and families manage these issues; (3) expand
ability to discriminate between transient and serious disturbances; (4) promote awareness of participants'
strengths and comfort in seeking consultation with colleagues; (5) facilitate a comprehensive approach
to health supervision as reflected in the Mental Health Initiative.
      The integral involvement of LEDBP fellows in COR is intended to promote and perpetuate
collaborative relationships and integrate DBP princip les into every day child health practices. A case-
oriented format is utilized to promote dialogue and shared consultation as participants rotate
responsibility for bringing case dilemmas for discussion. COR is committed to the highest standards of
confidentiality. An evaluation form provides information from each session for continuing quality
assessment, and guidance for direction of future meetings of COR.
7.    Multidisciplinary & Multispecialty Fellowship Seminar Series




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




Trainees: Fellows from UMN LEDBP, Interdisciplinary LEAH, Primary Care General Academic
Pediatrics, Healthy Youth Development Prevention Research Center, and Center for Adolescent
Nursing.
Faculty: LEDBP faculty, LEAH faculty, guest faculty and senior fellows. This set of LEAH seminars
comprises the core seminars for all interdisciplinary trainees.
Purpose/Training Content: Core topics in Research, Leadership, Advocacy, Maternal and Child Health,
Cultural Competency. All disciplines attend these seminars, according to their ILP’s. LEDBP Fellows
assume increasingly lead roles in teaching seminars in Years 2 and 3.
8. Grant Writing – PubH 7961
Trainees: LEDBP and LEAH fellows.
Faculty: AHC GCRC/Morrison
Purpose/Training Content: To develop skills necessary to write grant applications to either private or
public funding agencies. Topics include: funding, the elements of research and demonstration grants,
responding to Request for Proposals (RFP), developing needs assessment, the grant review process,
development of a grant proposal.
9.    Research Methodology with Foundations in Public Health
Trainees: LEDBP, MCH trainees
Faculty: UMN School of Public Health, College of Education, School of Nursing
Purpose/Training Content:
PubH 6600: Principles & Programs in Maternal and Child Health (Patterson)
PubH 6450: Biostatistics I & Biostatistics II (Telke)
PubH 6341/6342: Epidemiology I (Flood) & Epidemiology II (Pankow)
PubH 6742: Ethics: Research and Policy (Debruin)
PubH 6852: Program Evaluation in Health and Mental Health Settings (Garrard)
Nurs 5016: Critical Reading of the Literature (Resnick and Sieving)
CPsy 8360: Prevention Research in Children’s Mental Health (Masten, Reynolds, August)
10. Research Supervision
Trainees: LEDBP, LEAH fellows, Primary Care General Academic Pediatrics fellows
Faculty: M. Resnick, PhD, P. Scal, MD, MPH
Purpose/Training Content: Research supervision occurs in group and individual contexts.
Fellow Research Forum is a monthly meeting of all fellows for 90 minutes with the Research Director
(Resnick) or LEDBP Research Coordinator (Scal), for guided discussion, problem solving, and in-depth
discussion of current issues in fellows' research related to development of research questions,
measurement, sampling, design, analysis, and interpretation of data. The group context facilitates
sharing of interdisciplinary perspectives on the research process, and assures that each fellow makes
ongoing progress toward development of national conference presentations and submission of
manuscripts to peer-reviewed journals. Supplemental individual meetings are arranged as needed with
faculty to assure progress and growth in research skills and sophistication.
11. Intermediate and Advanced Clinical Hypnosis Training. LEDBP fellows are expected to annually
attend local Clinical Hypnosis Workshops, moving from Introductory training in Year 1 to Advanced in
Year 3.
Faculty: Variable as described below:
Purpose: To refine personal hypnotherapeutic skills; deepen knowledge and skill in application; and
develop expertise in teaching other professionals
Training Content: Varies. Includes in-depth presentations around specific areas (e.g., Hypnosis for Pain
Control) or a broad selection of skill applications.




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




Opportunities: Included in resources for trainees are:
a.     Annual Introductory, Intermediate, and Advanced Workshops in Clinical Hypnosis (General) –
       UMN & Minn. Society of Clinical Hypnosis (MSCH). Every June (20 hrs).
b.     Monthly to Quarterly Education Seminars - Minnesota Society of Clinical Hypnosis (MSCH) -
       Continuing education in hypnosis for members and guests of the MSCH, (250- member
       organization of therapists, nurses, physicians, and dentists).
c.     Annual Intermediate & Advanced Workshops in Pediatric Clinical Hypnosis (SDBP). Offered
       annually; 24-hour workshop. Extensive individual supervision practica.
d.     Outside of Minnesota, trainees may select training opportunities available monthly through the
       American Society of Clinical Hypnosis (ASCH) or annually through the Society for Clinical and
       Experimental Hypnosis (SCEH).
e.     “Creating Bright Futures: Annual Intermediate/Advanced Workshops in Pediatric Clinical
       Hypnosis – SUNY Upstate Med Ctr, (Next: Syracuse, NY May, 2008)
12. Health Behavior Change-Adolescent Actors Program
Trainees: Fellows from LEDBP, Interdisciplinary LEAH, Primary Care General Academic Pediatrics,
Healthy Youth Development Prevention Research Center, and Center for Adolescent Nursing.
Faculty: Mae Sylvester, R. Sieving, PhD
Purpose/Training Content: Enhance practitioners' skills in interviewing and intervening with adolesce nts
in interdisciplinary settings. Preparatory readings and initial group discussion focus on application of
theoretical models of health behavior change to clinical assessment and interventions with adolescents.
Each participant conducts 1:1 interview with trained adolescent actor who plays out a simulated scenario
involving a major health issue related to sexuality, substance use, eating behaviors, emotional distress,
family and social problems, and/or violent behavior. Following each simulation, feedback is given by
the adolescent actor, the instructor, and the other participants regarding interview content and process.
B. Didactic: Supple mental / Elective Curricula
1.     Child Psychology (CPSY) College of Education and Human Development ICD
       a. CPsy 5413: Early Childhood and Public Policy. State, federal, and international policies and
           legislative activity touching 1st 5 years of life. Family, community, and institutional roles in
           promoting children’s development.
       b. CPsy 8302: Developmental Psychology: Social and Emotional Processes
2.     Family Social Science (FSOS) College of Education & Human Development, Family Social
Science
       a. FSOS 5032 Family Systems Theories and Interventions. Thinking systemically about families
           across ecological systems. Theoretical frameworks. Role-playing.
       b. FSOS 8005 Multicultural Issues in Family Social Science
       c. FSOS 8101 Family Stress, Coping and Adaptation Helping families become more resilient to
           stress; decreasing vulnerability to crises, traumatic stress disorders.
3.     Public Health
       a. PubH 6613 Chronic Illness/Disability in Childhood: Principles, Programs
       b. PubH 6705 Community Health Assessment
       c. PubH 5634 Advocating for Change for Children. Strategies for changing systems, building
           skills in public policy research. (Oberg)
       d. PubH 6634 Advocacy and Children’s Rights
4.     Nursing
       a. Nurs 8193 Research Dissemination (Bearinger)
C. Community Observation Experiences will include:




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




1.    Day Care/Preschool Practicum
Purpose: Observe/participate in everyday activity of several different day cares preschools to promote
understanding of multidimensional aspects of this part of children's and families' lives.
Training Content: As a "clinical laboratory" for application and discussion of principles from the early
childhood core seminar first year LEDBP fellows will apply principles learned and prepare written
reports of three different children and child/adult interactions from observations during a half-day of
observation.
Observation sites:
     UMCCC (UMN Care Center) an "Educare" environment in UMN Dept. Education
     Gan Shelanu: Preschool of Adath Jeshurun Congregation, Minnetonka
     Lake Country School - A Montessori School Environment Minneapolis
2.    School Practicum
Purpose: To observe, experience, and participate in everyday activity of several different [elementary]
school environments to promote understanding and develop discerning observation regarding normative
and disruptive behaviors within the school environment.
Training Content: As a "clinical laboratory" for application and discussion of principles from the clinical
DBP sites, fellows will apply principles learned and prepare written reports of 3 different children from
observations during a half-day or day of observation; and/or [then] participate in an lEP assessment and
planning experience and conference.
Potential Observation sites:
     Anderson Public School - Minneapolis
     Mounds Park Academy
     Minneapolis Jewish Day School, St. Paul Talmud Torah Day School
     Anne Sullivan School for the Deaf
3.    Community Practicum
Purpose: To observe, experience, and participate in the everyday activity of different environments in
which young people may be living temporarily.
Training Content: Specific to each site, the fellow is expected to prepare learning objectives (in
collaboration with faculty) in advance of participation in a day of observation at these sites, and follow-
up with a written report of the experience, including 1) whether and how objectives were met; 2).
description of specific cases and/or interactions with identification of dia gnostic and/or treatment
dilemmas; and 3) personal reflections regarding fellow's personal reactions to the experience.
Potential Observation sites:
     Juvenile Detention Center - Hennepin County (Faculty mentor: G. Rosen, MD)
     American Indian Boarding School-The Pierre Indian Learning Center in Pierre SD (Faculty
        mentor: J. Reaney, MD or K. Murray, MD, MPH)
     The Bridge for Runaway Youth, Minneapolis (Faculty Mentor: LEDBP faculty)
     St. Joseph’s Home for Children (UMN LEDBP Faculty Mentor: P. Scal, MD, MPH)
     USpecial Kids Clinic (Faculty Mentor: A. Kelly, MD)
D. Fellows Core Clinical Expe riences & Supe rvision
1.    Individual Case Supervision - Core DBP Clinic Sites
Purpose: To provide continuing individual supervision and support for specific clinical cases of
evaluation and management; and to monitor and promote the Fellow's growth as a DBP clinician
consultant.
Training Content: Each fellow will be assigned to a faculty mentor at each clinical site. One- to 1.5-hour
supervision meetings will be held weekly (and at least every 2 weeks following the first 4-6 months) to




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




review the Fellow's active clinical cases and to discuss specific case(s) or clinical problem(s) in depth as
needed. A detailed ongoing log/journal of these meetings will be maintained. This ongoing review will
provide an opportunity to identify areas of strength and need in the Fellow's training experience; and to
provide constructive feedback. It will afford the fellow the continuing opportunity to review perceived
needs and difficulties. Often case review will be conducted by mutual review of videotaped sessions of
clinical encounters.
Training Sites: Ongoing opportunities for such reviews occur regularly in the context of each of the core
clinical training sites, i.e. the MN Regional Sleep Disorders Center, the Alexander Center for Child
Development and Behavior, the DBP Clinics of HCMC, the KDWB University Pediatrics Family
Center, and the Pediatric Integrative Medicine Program at Children’s Hospitals and Clinics of
Minnesota-Minneapolis campus.
2.    Individual Case Supervision – Required Supple mental Clinical Expe riences
Purpose: To provide continuing individual supervision and support for specific clinical cases of
evaluation and management; and to monitor and promote the fellow's growth as a DBP clinician
consultant in areas intimately related to DBP:
    a. KDWB University Pediatrics Family Center - Fetal Alcohol Syndrome Clinic (1 month)
        Training Content: Full range of Fetal Alcohol Effect/Syndrome
        Training/Supervisory Faculty: Pi-Nian Chang, PhD, Chris Boys, PhD
    b. U Special KIDS Clinic (1 month)
        Training Content: Children and youth with complex medical problems and associated disabilities
        including technology dependent.
        Training/Supervisory Faculty: Anne Kelly, MD
    c. KDWB University Peds Family Ctr-Pediatric/Adolescent Psychology (weekly, 3 months)
        Training Content: Evaluation/therapy for childhood psychological disorders
        Training Supervisory/Faculty: Chris Boys, PhD, Pi-Nian Chang, PhD
    d. KDWB University Peds Family Center - Eating Disorders Program (weekly, 3 months)
        Training Content: Evaluation and therapy for obesity, anorexia, bulimia
        Training Supervisory/Faculty: Diane Rubright, PsyD
    e. Pediatric Neurosciences (3- month block including Neuropsychology Clinic, weekly; Neurology
        Clinic, weekly; Autism Clinic, 2 half-days per week)
        Training Content: Clinical evaluation and management of neurodevelopmental disorders,
        developmental language and learning disorders, ADHD
        Training/Supervisory Faculty: Elsa Shapiro, PhD; Richard Ziegler, PhD; Steve Rothman, MD;
        Lawrence Charnas, MD; Michael Reiff, MD; Allison Golnik, MD, MPH
    f. Pediatric Psychiatry and Psychology (required)
        UMN Psychiatry Forensic Clinic /Wm Mitchell School of Law
            Training Content: 20-week series with forensic lectures on testimony, commitment, and
            interface between psychiatry and law.
            Training/Supervisory Faculty: Two law professors, two general forensic psychiatrists, one
            child and adolescent psychiatrist (Jonathan Jensen, M.D.), general psychiatry residents, child
            psychiatry fellow, UMN LEDBP fellows.
         UMN Psychotherapy Clinic (weekly)
            Training Content: Broad range of psychotherapy diagnosis & management challenges
            Training/Supervisory Faculty: Jonathan Jensen, MD; David Opsahl, MD; George Realmuto,
            MD (Child Psychiatry faculty)
         UMN Anxiety Clinic (weekly)




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




             Training Content: Anxiety disorders, including PTSD, OCD, phobias, school refusal
             Training/Supervisory Faculty: Gail Bernstein, MD (Child Psychiatry faculty)
    g. Gillette Children's Specialty Health Care – Developmental Disabilities (required)
         Training Content: Full range of developmental disabilities
         Training/Supervisory Faculty: Julie Hauer, M.D.
    m. Gillette Children's Specialty Health Care-Physical Medicine & Rehabilitation Clinic
          Developmental Disabilities Clinic
             Training Content: Full range of developmental disabilities
             Training/Supervisory Faculty: Julie Hauer, MD
          Gillette Children’s Specialty Health Care-Physical Medicine & Rehabilitation Clinic
             Training Content: Acquired injury from trauma or birth, static encephalopathies,
             degenerative diseases, traumatic brain and spinal cord injury (inpatient). Cerebral palsy,
             spina bifida, arthrogryposis, muscular dystrophies
             Training/Supervisory Faculty: Drs L. Krach, M. Gormley, S Quigley, M. Taniguchi
E. Cons ultation
1.     Primary Care Inpatient Consultation – UMN Children’s Hospital-Fairview.
    Age Range of Patients: 3 years - 20 years
    Number of Patients/month: 1-3
    Trainees: UMN LEDBP fellows
    Purpose: To develop consultative and leadership skills and refine collegial communication skills in
    collaboration regarding complex patient problems.
    Service provided: Consultative service as requested by other pediatric medical and surgical general
    and subspecialty services/.providers.
    Training Content: Varies with specificity of individual patient problems.
2.     Primary Care Clinics Consultation - Various sites - A program will be developed for UMN
LEDBP senior fellows to consult regularly with Pediatric Resident continuity Clinic sites for clinical
consultation and teaching in DBP issues in primary care
    Age Range of Patients: 2 - 18 years
    Trainees: LEDBP senior fellows
    Purpose: To develop consultative and leadership skills and refine communication and teaching skills
    in "on the spot" consultation with residents in Continuity Clinic sites.
    Service provided: Consultative services as requested by residents and their mentors, and concomitant
    education, both didactic and around specific cases.
F. Research
1.     Formal training in Research Methods and Manuscript Review - Emphasis on the significance and
clinical integration of research in DBP with the emphasis on applied clinical research in the context of
daily clinical and educational endeavors. Emphasis is placed on how everyday dbp consultation and
practice is informed and challenged by realities of what is known and is not yet known, and how we
might discover the answers through research. Integral to individual supervision is an expectation that
"the literature" and "the research" is, and becomes, a fundamental resource of the fellow's development.
     Formal educational seminars are provided..
2.     Additional Research Education Experiences include:
       (a) Faculty mentoring (each fellow has an individual Research Mentor);
       (b) Fellows' Seminar: Research in Progress Presentations (LEDBP and LEAH);
       (c) Collaboration with faculty in their ongoing research projects/programs.




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




3.    Independent Research Project - With formal coursework as grounding, and with the breadth of
clinical experiences in the first year, it is expected that the Fellow will develop an increased focus and
specificity of interest in the development of a unique biobehavioral research project. Depending upon
the nature of the project and data to be collected and analyzed, it is anticipated that the increased focus
on research should eventuate in preparation during the second year of at least one ABSTRACT for
presentation at a scientific meeting. In Year 3, it is expected that the project will have evolved toward
completion with publication in a scientific journal of the results of at least one research project. As
additional research is completed, it is expected that it will be presented in an academic environment and
ultimately published appropriately.
G. Opportunities for Development of Self-Understanding/Enrichment
      Self- understanding and self-awareness play an integral role in the development of excellence and
effective clinical, leadership, and advocacy skills. Specific promotion of self- understanding and personal
growth is accomplished through various formal and informal components of the LEDBP training
program:
      1. Ongoing weekly individual supervision and mentoring (each core clinical site);
      2. Videotape review of fellow clinical interviewing and treatment;
      3. Workshop training and individual supervision in clinical hypnosis and Biofeedback, including
          videotape review of fellow's clinical skill development in these self- regulation training
          strategies.
H. Continuing Medical Education - The LEDBP training program faculty organizes, implements,
and teaches a variety of CME activities at the local, regional, national, and international level. These
include the following offerings:
1.    Annual Introductory, Intermediate and Advanced Workshops in Clinical Hypnosis : LEDBP faculty
      develop and teach in this annual Course, co-sponsored by MSCH. The 37th annual Course,
      scheduled for May/June 1008, promises to attract hundreds of clinicians for introductory/advanced
      learning in hypnosis.
2.    Annual Family Practice Update – In 2008, LEDBP faculty will again present a DBP Workshop as
      part of this annual CME program. DBP faculty has been part of this endeavor since 1985.
3.    Topics and Advances in Pediatrics - LEDBP faculty will in 2008 provide a Workshop in DBP for
      the annual Pediatric Department CME Course. Previous workshops (since 1987) have focused
      upon common pediatric problems, e.g., persistent somatic complaints, sleep problems, movement
      disorders, chronic illness, ADHD, etc.
4.    Collaborative Office Rounds (COR) has been a successful joint venture of LEDBP and UMN
      Child Psychiatry under a grant from MCHB since 1996 (details in A.6, pg 3).
5.    DBP Grand Rounds – Collectively, the LEDBP program core faculty present 9-10 Grand Rounds
      per year on DBP issues of interest to the general pediatric community. These include 2-3 Grand
      Rounds at a large Minneapolis community hospital (Methodist Hospital, St Louis Park MN), 3-4
      Grand Rounds at the Children’s Hospitals, two Grand Rounds at the UMN Children’s, and several
      invited programs outside of Minnesota.
6.    Annual Workshop in Pediatric Biofeedback is presented by LEDBP training program faculty (T.
      Culbert, J. Reaney, R. Kajander) as part of most national Annual Meetings of Association of
      Applied Psychophysiology and Biofeedback (AAPB) or under auspices of STENS Corp.
      Biofeedback (National) Training Programs.
7.    Annual Workshops (Introductory, Intermediate, Advanced) in Pediatric Clinical Hypnosis are
      presented by LEDBP Faculty (D. Kohen, J. Reaney, T. Culbert) and others as part of each




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




     national Annual Meeting SDBP, annually in September. These three-day workshops were
     developed by LEDBP faculty.
8.   LEDBP Faculty are frequent speakers, workshop and seminar leaders at meetings of various
     national organizations including SDBP, the American Society of Clinical Hypnosis, the Society
     for Clinical and Experimental Hypnosis, the American Sleep Disorder Association, the Association
     of Sleep Societies, the National Enuresis Society, the STENS Biofeedback Training Programs, the
     International Society of Hypnosis.
9.   Plan to develop and convene the LEDBP National Annual Meeting. The LEDBP will be pleased
     to develop and host the national MCHB LEDBP Annual Meeting in Years 3 or 4 of the project
     period. In the interest of promoting active, participatory learning in the context of both
     disseminating new information and promoting creative, innovative research, UMN LEDBP
     proposes to develop and implement a unique and participatory educational expe rience for the
     program meeting: Growing out of our experience with this methodology in presenting 3 very
     successful National Behavioral Symposia in the 1980’s, and the ongoing successful COR
     experience (11 years), this case-based program will engage each MCHB LEDBP program to
     prepare a video vignette of a clinician-patient/family encounter for possible inclusion. Selected
     vignettes will be utilized as focal points and triggers for discussion in small, leaderless learning
     groups mixed by faculty and fellows. Simultaneously, a pre-selected “expert panel” will consider
     and discuss the video, and their panel discussion will be digitally recorded and shown as
     “feedback” to the several small groups following their own discussions. The groups will then come
     together for a brief summary presentation and discussion. It is anticipated that 3-4 such vignettes-
     discussion cycles will take place during the Annual DBP Program meeting.
   a. Participatory learning:
        Utilization of videotapes of actual clinician/patient (family) encounters as “trigger” stimuli
           for participant discussion in leaderless groups.
        Identification of “expert panels” to respond to videotaped clinical encounters, and have the
           response tape “fed back” to groups for discussion.
        Invitation of a guest speaker to present a 10-15 minute “state of the art” talk on the issues in
           question in the video encounter. To develop this program will require advance program
           planning of 18-24 months. The almost universal success of this methodology promoted a
           variety of positive spinoffs for student, resident, fellow, and graduate medical education, with
           ongoing utilization of videos in various learning experiences.
   b. Participatory teaching:
        Each Fellowship Program will be asked to produce 1 clinical video vignettes as
           “triggers”/“unknowns” for presentation.
        Faculty for will be sought both from within MCHB programs and from outside resources.
   c. Evaluation: As a model for assessment of efficacy in training, education, and research, an
       evaluation tool will be developed for assessment of this program, with particular reference to
       identification of short and long term benefits of both the program content and its process.

Inte rdisciplinary Fellows hip Training
Seminar Topic Ove rvie w

Intraprofessional, Interprofessional, and Interpersonal Develop ment
* Professional Develop ment Seminars
* Interdisciplinary Dynamics
* Building a Professional CV (2 sessions)




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




* Social Context and Adult/Adolescent Commun ication
* Negotiation and Conflict Management
* Negotiating a Pro fessional Position
* Giv ing and Receiv ing Constructive Feedback

Health and Social Systems
* Youth Culture
* Cultural Construction of Race: Imp licat ions for Research
* Public Health and Medical Care Systems
* Principles of Co mmun ity-Based Participatory Research
* Principles of Co mmun ity Partnerships

Pro moting Health Develop ment in Ch ild ren and Adolescents
* Cognitive, Social and Emotional Develop ment (2 sessions)
* Healthy Youth Develop ment: Challenges and Successes (3 sessions)
* Mental and Emotional Health Pro mot ion
* Applying Health Behavior Change Theories to Research and Practice (2 sessions)
* Train ing in Cognitive Behavioral Therapy

Health Needs of Children and Adolescents
* Statistical Overview of M innesota Youth
* Special Populations: GLBT Youth
* Adolescent Sexuality (2 sessions)
* Vio lence Prevention: Office Intervention
* Chronic Conditions and Transition to Adulthood
* Habits of Highly Effective Counselors When Assessing and Treating Adolescent Drug Abuse
* Eating Disorders: Prevention and Treatment
* Nutrit ion, Obesity and Body Image
* Adolescents and Adults: Another Look at Brains and Behavior (YouthCHAT panel)

Skills for Scholarship
* Data Fair (annual; to introduce fellows to current research projects and datasets)
* Conducting the Comprehensive Literature Search (taught by personal at Health Sciences Library)
* Research Guidance
* Research Logic and Methods
* Scientific Writ ing
* Social Context and Adult/Adolescent Commun ication (includes interviewing skills practice with youth from Adolescent
Actors Teaching Project)

Dissemination and Diffusion of Research and Best Practices
* Teaching Health Professionals
* Presenting Research to Scientific Audiences (“Public Speaking”)
* Advocacy and Policy: Working with Legislators
* Co mmunicat ions Workshop: Framing the Issues
* Preparing Public Testimony (2 t rain ing sessions; 1 practice session; presentation of testimony)
* Presentation of Testimony to Mock Leg islative Panel
* Effectively Presenting a Research Poster
* Fellowship Research Day (poster / platform presentations of fellows’ research for current year)

PROFESSIONAL DEVELOPMENT S EMINARS

* Sharing Research Interests
* Balancing Personal and Professional Life
* Job Talk and Interview Skills
* Giv ing and Receiv ing Constructive Feedback




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




Conferences
The table below provides a listing of the major conferences offered and the frequency at which they
occur.

          Conference                    R, O       Frequency            Person(s) responsi ble for             Hos pital
                                                                         conducting conference                  1, 2, 3
Collaborative Office Rounds         R           2nd & 4th             Co-M oderators are Director of       1
(COR) : Pediatrics & Child                      M ondays              Behavioral Pediatrics (Kohen) &
Psychiatry                                      7:45-9:00 am          Director of Child Psychiatry
                                                                      Training Programs (Jensen)
                                                                      Conferences presented by all
                                                                      regular and ongoing clinician
                                                                      participants
COR III – “Residents’ COR” for      R           M onthly; 3rd         Co-moderators are Senior Fellow      1
senior residents in Pediatrics &                M onday each          in Academic General Pediatrics
Psychiatry                                      month (12:15-1:15     (A. Goel); junior faculty, both of
                                                pm)                   whom are DBP fellow grads (A.
                                                                      Barnes, B. M urray}; fellows in
                                                                      Child/Adol Psychiatry; Dr Dan
                                                                      Kohen (COR Program Director)
Cultural Competency Sequence:       R           Bi-monthly –          Senior DBP Fellows and               1
 • Reflective Practice Conference               1.5 hours             Faculty M . Strachan, M .D.
 • Cultural Competence Wrkshop      R           Semi-Annual           M ae Sylvester, M .S., Adolescent    1
                                                Half-day Wrksop       Actors – Fellow Interviews
                                                                      Videotaped
 • Parents-as-Teachers (P.A.T.)     R           Weekly x 4            Parents of Children with Chronic     A
                                                                      Illness and Disabilities
                                                                      P. Scal, M .D.
                                                2/year Home vis.      Fellows, Parents
M ultidisciplinary Assessment &     R           Weekly                J.Reaney, M D, R. Kajander,          2
Case M anagement Conference                                           CPNP, J. Lessin, MD, T. Scott,
Developmental-Behav Pediatrics                                        MD.,, Psychologists, Fellows
Neuropsychology/Neurobehavioral     R(during    Weekly                L. Charnas, M .D.                    1
Conference Series                   clinical                          R. Ziegler, Ph.D.
                                    rotation)
Understanding and M anaging Pain    R           4 hour seminar        D. Kohen, M .D.                      1
(Tutorial)
Psychopharmacology Course           R(during    Weekly (4 mos)        J. Jensen, M .D.                     1
                                    clinical
                                    rotation)
Health Behavior Change I            R           8 hour seminar        R. Sieving, CPNP, Ph.D.              1
Health Behavior Change II                       (x 2)
Sexual and Physical Abuse in        R           2 hour seminar        M . Hogan, M .D.                     1
Childhood
Violence Prevention Seminar         R           8 hour seminar        I. Borowsky, M .D., Ph.D.            1

Adolescent Substance Use - Trends   R           8 hour seminar        P. Scal, M .D., M PH                 1
& Prevention
Developmental-Behavioral            R           Bi-Weekly -1. 5h      Fellows                              1 or 2 or 3
Pediatrics Peer-Grp Supervision
Clinical Case Review Conference
Individual Clinical Case            R           Weekly – 1 hour       Fellow and (1) DBP Faculty           1 or 2 or 3
Supervision & M entoring DBP
Core Lectures: Pediatric Sleep      R(during    Weekly (during        G. Rosen, M .D., MPH;                3
M edicine                           clinical    clinical rotation)    L.Wills, M .D.
                                    rotation)
Child/Adolescent Nutrition          R           8 hour seminar        M . Story, Ph.D.                     1
Seminar (8 hrs): Story, Neumark-                                      D. Neumark-Sztainer, Ph.D.




                                                                 34
Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




Sztainer
Research Curriculum
 • Research M ethods & Logic          R           M onthly                 M Eisenberg, SciD, M PH, fellows   1
 • Research Guidance                  R           M onthly                 M . Resnick, PhD, Fellows
 • Research Supervision               R           Variable                 Fellow & Research M entor
Organization U.S Health Services      R           8 –hour seminar          M . Resnick, Ph.D. Dir. Research   1
Principles Public Health Research     R           1 quarter course         Judy Garrard, PhD                  1
Psychotherapy Case Conference         R(during    Weekly (during           DBP Fellows, Child Psychiatry      1
                                      clinical    clinical rotation)       Fellows
                                      rotation)
Introductory Pediatric Clinical       R           24 hour Workshop         National Training Faculty          1
Hypnosis Workshop                                                          S ociety for Developmental and
                                                                           Behavioral Pediatrics

Introductory Workshop-General         R           20 hour Workshop         M innesota Society of Clinical     1
Clinical Hypnosis                                                          Hypnosis Training Faculty

                                                  24 hour Workshop
Intermediate and Advanced             R                                    National Training Faculty
Pediatric Clinical Hypnosis                                                S ociety for Developmental and     1
Workshop                                                                   Behavioral Pediatrics
Introduction to Clinical              O           50 hour workshop         National Training Faculty-Stens    Variable
Biofeedback                                                                Corporation and Association for
                                                                           Applied Psychophysiology and
                                                                           Biofeedback
Craniofacial Clinic - Team Case       R(during    M onthly                 Interdisciplinary Team             1
Conference                            clinical                             L. Wills, M .D.
                                      rotation)
Cochlear Implant Team Case            R(during    M onthly                 Interdisciplinary Team             1
Conference                            clinical                             L. Wills, M .D.
                                      rotation)
Effective Teaching of Adults           R          90-minute seminar        K. Brothen (M N Dept of Educ)      1
PA 5-941/5-942 Leadership for the      R          1 quarter course         Reflective Lrning Ctr Humphrey     1
Common Good                                                                Inst Public Affairs UM N
Professional/Career Development       R           8 hour s of seminars     Interdisciplinary Training         1
Seminar                                                                    Faculty (medicine, nursing,
• Working with the M edia                                                  nutrition, psychology, social
• Developing a Professional CV&                                            work, research, epidemiology,
Writing an Effective Cover Letter                                          public health)
• Interviewing for a Job &
Negotiating a Contract
• Myers-Briggs Type Indicator
(including results for each person
and applied interpretation of those
results)
CPsv 8360 Developmental               R           1 quarter course         M . Gunnar, Ph.D. Institute of     1
Psychobiology of Stress- Seminar:                                          Child Development
CPsv 8360 Seminar Brain               O           1 quarter course A.      Nelson, PhD; A. M asten, PhD       1
Development & M ental Health:                                      B.      Institute of Child Development
Develop Psychopathologv meets the
90's Neurosciences
Beh-Dev Pediatric Grand Rounds        R           Variable – When          BDP Faculty (local, regional,      1, 2, 3, A, B
                                      (during     Ped Gd Rds at            national)
                                      clinical    various sites are
                                      rotation)   DBP focus
Introduction to Therapeutic           R           Bi-annual 2 hour         D. Kohen, M .D.                    1
Communication & Hypnosis for          (during     seminar
Nurses (Health Care for Children      clinical
with Special Health Care Needs -      rotation)
Nurse Practitioner Nursing Course)




                                                                      35
Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




Teaching Responsibilities
Developmental- Behavioral Pediatrics fellows are actively involved in teaching Pediatrics/Medicine-
Pediatrics residents on the Developmental-Behavioral Pediatrics rotation. Fellows rotation with DBP
faculty to lead some of the weekly seminars in the “Fundamentals of Child Development and Behavioral
Observations” curriculum series; this curriculum is closely linked to residents’ observational
experiences at the University of Minnesota Child Care Center (UMCCC). DBP fellows also do a case
presentation at the Department of Pediatrics’ weekly 3M Conference. When serving as coordinator for
the “Residents’ COR” (Collaborative Office Rounds: Pediatrics & Child Psychiatry) monthly seminar,
DBP fellows work closely with the resident assigned to present, aiding the resident in concisely
presenting the case and then helping facilitate discussion following the presentation.


PROGRAM GOALS AND OBJECTIVES
Refer to the independent program document, Goals and Objectives, for this information. This document
is located at: http://www.med.umn.edu/peds/education/fellowships/administration/goals/home.html.


ACGME CORE COMPETENCIES
All University of Minnesota Medical School Fellowship training programs define the specific
knowledge, skills, attitudes, and educational experiences required by the RRC to ensure its
residents/fellows demonstrate the following:

Patient Care - Fellows must be able to provide patient care that is compassionate, appropriate, and
effective for the treatment of health problems and the promotion of health.

Medical Knowledge - Fellows must demonstrate knowledge of established and evolving biomedical,
clinical, epidemiological and social-behavioral sciences, as well as the application of this knowledge to
patient care.

Practice-based Learning and Improvement – Fellows must demonstrate the ability to investigate and
evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously
improve patient care based on constant self-evaluation and life- long learning. Fellows are expected to
develop skills and habits to be able to meet the following goals:
     identify strengths, deficiencies, and limits in one’s knowledge and expertise;
     set learning and improvement goals;
     identify and perform appropriate learning activities;
     systematically analyze practice using quality improvement methods, and implement changes
        with the goal of practice improvement;
     incorporate formative evaluation feedback into daily practice;
     locate, appraise, and assimilate evidence from scientific studies related to their patients’ health
        problems;
     use information technology to optimize learning; and,
     participate in the education of patients, families, students, residents and other health
        professionals.




                                                    36
Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




Interpersonal and Communication Skills - Fellows must demonstrate interpersonal and communication
skills that result in the effective exchange of information and collaboration with patients, their families,
and health professionals. Fellows are expected to:
     communicate effectively with patients, families, and the public, as appropriate, across a broad
         range of socioeconomic and cultural backgrounds;
     communicate effectively with physicians, other health professionals, and health related agencies;
     work effectively as a member or leader of a health care team or other professional group;
     act in a consultative role to other physicians and health professionals; and,
     maintain comprehensive, timely, and legible medical records, if applicable.

Professionalism - Fellows must demonstrate a commitment to carrying out professional responsibilities
and an adherence to ethical principles. Fellows are expected to demonstrate:
     compassion, integrity, and respect for others;
     responsiveness to patient needs that supersedes self- interest;
     respect for patient privacy and autonomy;
     accountability to patients, society and the profession; and,
     sensitivity and responsiveness to a diverse patient population, including but not limited to
       diversity in gender, age, culture, race, religion, disabilities, and sexual orientation.

Systems-based Practice - Fellows must demonstrate an awareness of and responsiveness to the larger
context and system of health care, as well as the ability to call effectively on other resources in the
system to provide optimal health care. Fellows are expected to:
     work effectively in various health care delivery settings and systems relevant to their clinical
       specialty;
     coordinate patient care within the health care system relevant to their clinical spec ialty;
     incorporate considerations of cost awareness and risk-benefit analysis in patient and/or
       population-based care as appropriate;
     advocate for quality patient care and optimal patient care systems;
     work in inter-professional teams to enhance patient safety and improve patient care quality; and
     participate in identifying system errors and implementing potential systems solutions.


PROCEDURES
Fellows will participate in a gynecological exam workshop early in the first year of fellowship training,
after which they will be observed at least once by a faculty member while they perform a patient pelvic
exam at the Fairview Children’s Clinic. In the second or third year, they will observe the placement of
contraceptive intra-uterine devices (IUD’s) and/or subcutaneous hormonal depot implants (“Implanon”)
at Face to Face Clinic by on-site medical preceptors. After observing the placement of these several
times, they will be observed performing these procedures, and then when found to be proficient,
expected to perform them without supervision thereafter.

DUTY HOURS
      Duty Hours are defined as all clinical and academic activities related to the training program, i.e.,
       patient care (both inpatient and outpatient), administrative duties related to patient care, the
       provision for transfer of patient care, time spent in- house during call activities, and scheduled




                                                     37
Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




       academic activities such as conferences. Duty hours DO NOT include reading and preparation
       time spent away from the duty site.
      Duty hours are limited to 80 hours per week, averaged over a four-week period, inclusive of all
       in- house call activities.
      Fellows are provided with 1 day in 7 free from all educational and clinical responsibilities,
       averaged over a 4-week period, inclusive of call.
      The training program provides adequate time for rest and personal activities, which consists of a
       10-hour time period provided between all daily duty periods and after in- house call.
      All fellows are required to track their duty hours in New Innovations’ Residency Manageme nt
       Suite (RMS).
      Programs review this duty hour information on a quarterly basis to address violations.
      More information about duty hours is available in the Pediatric Program Manual.

ON-CALL
Developmental- Behavioral Pediatrics fellows do not currently provide on-call coverage in the hospital,
due to the fact that on-call and night coverage of the General Pediatric and Adolescent services at the
University of Minnesota Hospital is provided for by a pediatric faculty member serving in a hospitalist
role.

SCHEDULING
Fellows meet with the Fellowship Program Director twice a year to discuss scheduling options based on
educational considerations. These are documented in an Individualized Learning Plan, and reviewed
every six months for progress and ongoing/ emerging educational needs.


ABSENCE COVERAGE
There are a number of situations in which a fellow may be unable to fulfill his or her scheduled
responsibilities. These include sickness, disability, pregnancy, personal reasons and educational reasons.
In these cases, a coverage arrangement must be determined with Dr Nimi Singh, the Program Director.


BACK-UP POLICY
Resident and fellow well-being will be closely monitored by the training program and supervising
faculty. Faculty and fellows are educated to recognize the signs of fatigue and will adopt and apply
policies to prevent and counteract the potential negative effects. Instruction on accessing Fatigue
curriculum is available at:
http://www.med.umn.edu/gme/residents/orientation/home.html#GMEMoodle. If a trainee feels they
cannot provide safe patient care, they should immediately contact the supervising faculty, who will
excuse the trainee from patient care responsibilities until the trainee is rested and able to provide safe
patient care again. Once the trainee is excused, their patient care duties will become the responsibility of
the supervising physician, utilizing any additional identified back-up systems as needed. Any other
faculty member, fellow or member of the health care team who identifies a fellow as being fatigued
should also contact the supervising faculty to suggest removal of the fellow until safe patient care can
once again be provided.




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Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




MONITORING OF FELLOW WELL-BEING
The program director is responsible for monitoring resident stress, including mental or emotional
conditions inhibiting performance or learning, and drug-related or alcohol-related dysfunction. Both the
program director and faculty should be sensitive to the need for timely provision of confidential
counseling and psychological support services to residents. Situations that demand excessive service or
that consistently produce undesirable stress on residents must be evaluated and modified. Refer to the
Back-Up Policy for instruction on what to do if a fellow is fatigued or stressed, especially if unable to
provide safe patient care.

SUPERVISION OF FELLOWS
The Program Director will act in the supervisory role for all fellows concerning matter s related to the
Developmental- Behavioral Pediatrics Fellowship Program. In clinic, the first-year fellows are in with
the attending and they discuss the cases together. The second- year transitions into more independent
thinking and patient care: fellows see patients without the attendings’ presence and then discuss specific
issues with the attending afterwards, unless attending consultation is needed to confirm physical findings
or manage complex issues the fellow is still unfamiliar with. In the third year, the fellow sees patients
and makes decisions but must confer with the attending regarding their decisions pertaining to patient
care. In the second-year and third- year of fellowship, when fellows provide in-patient care, hospital
rounds are within the presence of the supervising attending, but patient management and discussions are
led by fellows and/or residents. All supervisors have pagers for rapid and reliable means of
communication with the residents and fellows.

All patient care must be supervised by qualified faculty. The Program Director will ensure, direct, and
document adequate supervision of residents and fellows at all times. Fellows will be provided with
rapid, reliable systems for communication with supervising faculty. Fellows must be supervised by
teaching staff in such a way that they assume progressively increasing responsibility according to their
level of education, ability, and experience. On-call schedules for teaching staff must be structured to
ensure that supervision is readily available to fellows on duty. The teaching staff must determine the
level of responsibility given to each fellow.

EVALUATION
Evaluation is an essential component of the educational process and should contribute to the
professional growth of each fellow. Problems with expected performance or progress on the part of a
fellow should be identified and reported early. The evaluations of all fellows should be subject to regular
and frequent review. Mentors should be central to the review process. Evaluation sha ll extend to the
fellow notice of all information which is pertinent to the evaluation and an opportunity for concerns to
be communicated and heard.

Steps in the Evaluation Process
Appropriate faculty evaluator and evaluation setting are identified. The evaluation format and
instrument is defined. The evaluator determines and reviews sources of information pertinent to the
evaluation. Written evaluations are completed by the evaluator, using either the standard evaluation
form found in our online tool or, in exceptional circumstances, an ad hoc evaluation. Evaluations are to
be discussed with the fellow by the evaluator. The Fellowship Program Director can involve the
Resident Review Committee (RRC) for guidance on potential remediation situations. In accord with the




                                                    39
Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




fellow contract, if at any time the Evaluator, the Fellowship Program Director and/or the Chairperson of
the RRC determines that patient care or safety is jeopardized they may bring that information
immediately to an emergency meeting of the RRC and/or to the head of the Department of Pediatrics
who may suspend the fellow from patient care responsibilities.

Copies of the written evaluations are readily available to the fellow and his or her mentor via our online
tool, or sent upon request.

Fellows meet twice a year with the Program Director for evaluation, and the Program Director provides
a final evaluation for each fellow completing the program. Records of the evaluations on each resident
and fellow are accessible to them.

Possible Outcomes of Review by the Resident Review Committee (RRC)
The RRC may recommend one or more of the following as courses of action for the Fellowship Program
Director to pursue:
    1. Normal advancement with commendation
    2. Normal advancement within the training program.
    3. Medical and/or psychiatric appraisal as to suitability for continuation of fellowship training.
    4. Probation with continuation of normal rotations, but with more detailed and frequent evaluation.
        The fellow and his/her mentor are invited to appear before the RRC before an individual is
        placed on probation.
    5. Probation with loss of credit for a specified rotation or rotations deemed unsatisfactory by the
        RRC. The RRC may recommend that such non-credited rotations be satisfactorily repeated or
        that the fellow be assigned to a comparable remedial service or rotation.
    6. Immediate suspension with pay. The fellow is relieved of all duties relative to the fellowship
        training program. This action is temporary until one of the following is implemented.
    7. Probation with certain rotations or services to be repeated.
    8. Modification of the fellow's assigned program to provide remedial training in a special setting
        with a special assigned tutor(s).
    9. Dismissal from the program.
    10. Final written summary review on completion, of or depa rture from the program, to be entered
        into the fellow's permanent file.
Actions 5, 6, or 7 above will automatically require extension of the minimum training time necessary to
become eligible for the examinations of the American Board of Pediatrics.

Types of Evaluations
In accordance with ACGME requirements, all UMN pediatric fellowship programs are required to
collect multiple types of evaluations. The evaluations required to be collected via RMS include
(<change as needed for specific program>):
     Program Director Eval of Fellow (2X per year at minimum) -completed semiannually before
        progression meeting with Program Director
     Fellow Self-Eval (2X per year at minimum)-completed semiannually before progression meeting
        with Program Director
     Fellow Eval of Program (2X per year at minimum)-completed before semiannual progression
        meeting with Program Director




                                                    40
Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




      Faculty Eval of Fellow (2X per year at minimum)-completed quarterly during clinical year
       (CHMS-SP) or end of monthly rotation
      Faculty Eval of Program (1X per year at minimum)
      Fellow Eval of Rotation (2X per year at minimum)
      Fellow Eval of Core Curriculum (after each attended session)
      Fellow Eval of Faculty (1X per year at minimum)
      For patient/family evaluation and nurse evaluation, standard department forms are available from
       Fellowship Coordinator. At least 2x/year (or more if the PD prefers), the coordinator will give
       the fellow 5-10 of each of these evaluations to distribute. After distribution, the coordinator will
       collate the responses for the fellow file.

Evaluation Confidentiality
Evaluation confidentiality is of high importance in the department. A grid outlining evaluation
confidentiality is available at: http://www.med.umn.edu/peds/education/fellowships/current/home.html.

In order to maintain a confidential feedback system, there are several mechanisms in place:
     Only the program coordinator and Department Education Office have access to view the fellow
        identity for evaluations the fellow has completed on faculty.
     Evaluation of faculty teaching performance is included in all annual faculty performance
        evaluations. These evaluations are completed either by the Department Chair or Division Chair.
     In cases where there are few evaluators and evaluation results are inaccessible to the subject,
        summary results can be obtained from the coordinator or the Department Education Office.
     Coordinators receive annual guidance on how to collate evaluations to promote confidentiality.

Types of Assessments
<Include a similar chart to the one below if possible>
Sample:
                                                                              MEDICAL KNOWLEDGE




                                                                                                                   PROFESSIONALISM
                                                                                                  COMMUNICATION




                                                                                                                                     PRACTICE-BASED
                                                                                                  INTERPERSONAL/




                                                                                                                                                      SYSTEMS-BASED
                                                               PATIENT CARE




                                                                                                                                     LEARNING



                                                                                                                                                      PRACTICE
                                                                                                  SKILLS




   1. Written evaluations of competency in all areas of
      clinical care are completed by the faculty, through
      RMS. These evaluations/assessments are
      completed quarterly during the first year and semi-                                                                                         
      annually during the second and third years. The
      PEM subspecialty resident’s technical abilities are
      also assessed.
   2. 360º evaluations of the fellows are completed by
      the Health Unit Coordinators (HUCs), respiratory
                                                                                                                                                   
      therapists, social workers, interpreters, parents and
      ED nursing staff.




                                                    41
Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




   3. Each fellow must keep a procedural log. Any
      procedural complications are reviewed at the semi-
                                                                                           
      annual meeting with program director conference
      equivalents.
   4. ABP Subspecialty In-Service Examination (SITE)                   
   5. PALS certification                                              
   6. Participation in Resuscitation/M&M conferences                                           
   7. Participation in PEM fellow’s conference                                                  
   8. The Division provides each PEM subspecialty
      resident access to Pediatric Notes, Pediatric
      Emergency Medicine Reports, and Emergency
      Reports, which gives them another opportunity for                                   
      learning, self-assessment and hopefully
      establishing habits which will lead to life- long
      learning and regular CME.
   9. Simulation                                                                          


Annual Program Review
The program is evaluated in detail at least once per year. Minutes of the program review are to include
five key areas of performance. These five areas are:
     Current fellow performance (scholarly activity, # of procedures, SITE results)
     Faculty development (development opportunities including new clinical skills, admin skills, and
        teaching, scholarly activity, statement that performance has been reviewed)
     Graduate performance (board results)
     Overall program evaluation (discussion of fellow and faculty evals)
     Action plan (any follow- up, address deficiencies)

Subspecialty In-Training Examination (SITE)
Every fellow is required to annually assess through their SITE. Once the announcement about SITE is
received from the American Board of Pediatrics (usually by e- mail to Program Director), fellows will be
notified. Fellows will arrange through Deb Seyfer to register for SITE each year. The results are
discussed between the fellowship director and fellow at their semi-annual review.

Residency Management Suite (RMS)
Refer to Pediatric Program Manual at:
http://www.med.umn.edu/peds/pedsres/current/programmanual/general/rms/home.html


TRAINING/GRADUATION REQUIREMENTS
Upon successful completion of all program requirements, the Fellowship Director will provide a final
summative evaluation for each fellow who completes the program. The program requirements are in
accordance with the requirements outlined by the ABP and ACGME. This evaluation will include a
review of the fellow’s performance during the final period of training and will include verification that




                                                    42
Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




the fellow has demonstrated sufficient professional ability to practice competently and independently.
This final evaluation will be part of the fellow’s permanent record.

TEACHING MEDICAL STUDENTS
Refer to Pediatric Program Manual at:
http://www.med.umn.edu/peds/pedsres/current/programmanual/general/teaching/home.html

ACLS/BLS/PALS RECERTIFICATION
Individual hospitals will provide training for required certifications. Contact Fairview Organizational
Learning at 612-273-6195 to determine your required training.

AMA POLICY FOR ACCEPTING GIFTS
Refer to Pediatric Program Manual at:
http://www.pedsres.umn.edu/current/programmanual/general/otherpolicies/giftpolicy/home.html

MEDICAL RECORD/DICTATION COMPLETION
Refer to Pediatric Program Manual at:
http://www.pedsres.umn.edu/current/programmanual/general/otherpolicies/records/home.html

CONTINUITY OF CARE
Refer to Pediatric Program Manual at:
http://www.pedsres.umn.edu/current/programmanual/general/otherpolicies/continuity/home.html

DEMONSTRATION OF ENGLISH LANGUAGE PROFICIENCY BY NON-NATIVE
SPEAKERS OF ENGLISH
Refer to Pediatric Program Manual at:
http://www.pedsres.umn.edu/current/programmanual/general/otherpolicies/proficiency/home.html

GUIDELINES FOR PROFESSIONAL DRESS
Refer to Pediatric Program Manual at:
http://www.pedsres.umn.edu/current/programmanual/general/otherpolicies/dress/home.html

PROFESSIONAL INTRODUCTION GUIDELINES
Refer to Pediatric Program Manual at:
http://www.pedsres.umn.edu/current/programmanual/general/otherpolicies/introduction/home.html

MEDICAL LICENSURE
You are not required to have a state license to participate in UMN Pediatric Fellowship Programs,
although state law mandates that each fellow have a training permit (aka, residency permit). The
Department of Pediatrics will issue a permit application form to you for completion. This must be done
BEFORE starting any rotations. This is a one-time application and is valid throughout your fellowship.

You are responsible for COMPLETION, AND COORDINATION of all licensing activities! Send
a copy of your Minnesota license to the Departme nt Education Office for your file. If you wish to




                                                    43
Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




obtain a license (remember, this is an option NOT a requirement) or you have questions regarding
licensing, you may contact the state board directly at:
                      Minnesota Board of Medical Practice
                      University Park Plaza
                      2829 University Avenue SE, Suite 500
                      Minneapolis, Minnesota 55414-3246
                      (612) 617-2130          (612) 617-2166 (fax)
You can also find information about the process of obtaining a medical license on the pediatric website.

MOONLIGHTING POLICY:
All moonlighting must be approved prospectively by your program director. The prospective
moonlighting request/approval form is at:
http://www.med.umn.edu/peds/education/fellowships/current/home.html.

Full moonlighting policy and procedure are at:
http://www.med.umn.edu/peds/pedsres/current/programmanual/general/otherpolicies/moonlighting/hom
e.html.

ON CALL ROOMS, SUPPORT SERVICES,
LABORATORY/PATHOLOGY/RADIOLOGY SERVICES
 Refer to Pediatric Program Manual at:
http://www.pedsres.umn.edu/current/programmanual/general/otherpolicies/services/home.html

MEDICAL RECORDS
Refer to Pediatric Program Manual at:
http://www.pedsres.umn.edu/current/programmanual/general/otherpolicies/records/home.html

SECURITY/SAFETY
Refer to Pediatric Program Manual at:
http://www.pedsres.umn.edu/current/programmanual/general/otherpolicies/safety/home.html

UNAUTHORIZED LEAVE
A fellow taking unauthorized leave will be subject to disciplinary procedures, including probation and/or
termination.




                                                   44
Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




SECTION 6 – ADMINSTRATION
(Please refer to Institution Policy Manual at
http://www.med.umn.edu/gme/residents/instpolicyman/home.html for Medical School Policies on the
following: University of Minnesota Physicians, GME Administration Contact List, GME Administration
by Job Duty; GME Organization Chart.)


DEPARTMENT OF PEDIATRICS: ADM INISTRATION
Head of the Department of Pediatrics
Aaron Friedman, M.D., Head
PWB 13-118
Telephone: (612) 624-3113

Pediatric Education Office
PWB 13-168
Telephone: (612) 624-4477, #1
FAX: (612) 626-7042
Internet: http://www.med.umn.edu/peds/education/fellowships/home.html

Education Manager/Department Fellowship Administrator: Emily Gray
612-624-0410/ elgray@umn.edu

Associate Fellowship Administrator: Valerie Cole
612-624-8788/ cole0430@umn.edu


DIVISION OF ACADEM IC GENERAL PEDIATRICS
DEPARTMENT OF PEDIATRICS:

717 Delaware Street SE                              Phone (Division main line) 612-626-2820
3rd floor west                                      FAX 612-626-2134
Minneapolis, MN 55414

Daniel P. Kohen, MD - Director, Developmental-Behavioral Pediatrics Fellowship
Program
612-626-4260 (voice mail 612-626-3014) pager 612-899-7438 dpkohen@umn.edu

Deb Seyfer - Coordinator, Adolescent Medicine Fellowship Program
612-626-2953 (FAX 612-626-2134) dappe001@umn.edu

DEPARTMENT OF PEDIATRICS: PAYROLL
Payroll Specialist: Deb Slavin
612-626-6910/ slavi002@umn.edu




                                                   45
Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




Pediatrics, Ob/Gyn and Women's Health
Room 353-37
717 Delaware Street SE
Minneapolis, MN 55414




                                                46
Program Manual Addendum for Developmental-Behavioral Pediatrics Fellowship Program (2010-2011)




Confirmation of Receipt of your Fellowship Addendum for
Academic Year 2010-2011
By signing this document you are confirming that you have received and reviewed your Fellowship Addendum
for this academic year. This policy manual contains policies and procedures pertinent to your training program.
This receipt will be kept in your personnel file.

Fellow Name (Please print) _______________________________________________


Fellow Signature ________________________________________________________

Date __________________



Coordinator Initials ________________

Date __________________




                                                       47

				
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