Objectives

Module: Pulmonary Exam

  • Assess level of respiratory distress including ability to vocalize, mental status and positioning
  • Assess work of breathing including use of accessory muscles, grunting and flaring
  • Assess breath sounds in all lung fields
  • Describe normal and abnormal breath sounds

Module: Ear Exam

  • Identify visual cues for acute otitis media
  • Formulate a treatment plan dependent upon physical exam findings and history
  • Properly position an uncooperative patient for evaluation of the ears
  • Use otoscope to visualize the tympanic membranes and describe findings

Module: Neuro Exam

  • Engage children of different ages and cooperation levels in assessment of central and peripheral strength & sensation
  • Demonstrate how to assess cranial nerves at different ages
  • Demonstrate how to assess reflexes
  • Describe abnormal findings on the newborn and infant neuro exam

Module: Newborn Exam

  • Describe strategies to successfully complete a head to toe exam on a newborn
  • Identify common findings, both benign and pathologic, on the newborn exam
  • Demonstrate proper swaddling techniques

Module: US

  • Describe the common uses for bedside ultrasound in pediatrics
  • Demonstrate peripheral IV placement under US guidance
  • Identify foreign bodies on POC US

Module: Assessment and Plans

  • Develop succinct assessments and plans based on history and physical exams for common pediatric complaints
  • Formulate assessments and plans by both problems and systems
  • Present assessments and plans orally to a group of peers and supervisors

Module: To-do lists and prioritization

  • Devise lists of tasks that must be accomplished during a simulated work day
  • Devise strategies to prioritize work-load

Module: RN Communication and Answering Pages

  • Describe the goals of interprofessional communication
  • Identify challenges in interprofessional communication
  • Identify the purpose of pages:
  • Notification
  • Question
  • Concern
  • Identify potential pitfalls in answering pages
  • Triage pages to identify when you to need to assess the patient in person
  • Construct answers to pages on hypothetical patients

 

Module: Handoffs

  • Discuss the importance of effective handoffs
  • Identify strategies to improve handoff communication
  • Employ a handoff mnemonic
  • Practice effective handoff communication

 

Module: Bugs & Drugs

  • Identify the most common infections in children and their potential complications: OM, orbital/periorbital cellulitis, osteomyelitis, peritonsillar abscess
  • Strategize approaches to working up different infection
    • Use of blood cultures, CPR, ESR, CBC
    • Clinical signs of infection
  • Explain approaches to treatment of various infections
    • Describe how to chose the appropriate initial antibiotic coverage and how to narrow coverage (introduction to Sanford guide)
    • Read an antibiogram
    • Identify the contraindications and side effects of certain drugs in the pediatric population
      • Risks of fluoroquinolones in children
      • Renal toxicity of vancomycin
      • Cephalosporin resistance

 

Module: Alternative Immunization Schedules

  • Recognize with the common concerns parents have about immunizations
  • Risk of autism
  • Mercury and other adjuvants
  • Overwhelming the immune system
  • Develop an approach to the discussing these concerns with parents
  • Develop an approach to providing data about immunizations in an understandable and compelling manner

 

Module: Immunization Talk- Developing your “spiel”

  • Identify the current AAP Immunization schedule and be able to discuss the pros and cons of the various alternative schedule
  • Debate with the common concerns parents have about immunizations
    1. Risk of autism
    2. Mercury and other adjuvants
    3. Overwhelming the immune system
    4. Use of fetal cells
  • Develop an approach to discussing these concerns with parents while providing data about immunizations in an understandable and compelling manner
  • Identify resources to help parents become more educated on immunizations

 

Module: Alternative Immunization Schedules

  • Describe common “alternative schedules”
  • Identify common myths about vaccines perpetuated on the internet
  • Identify online resources for families to help provide sound information on vaccines

Module: Prescriptions Pearls

  • State the required components of a written prescription
  • Identify acceptable abbreviations for common prescription elements
  • Write accurate and correct prescriptions for pediatric patients

 

Module: Splinting

  • List common indications for splint application in pediatric patients
  • Design an appropriate splint type for a given injury
  • Create splints using padding, fiberglass and bandages

 

Module: Umbilical catheter placement

  • List common indications for UVC and UAC placement
  • Demonstrate placement of lines on a task trainer

 

Module: Informed Consent

  • Define informed consent
  • List the components of informed consent
  • Explain the risks, benefits and alternatives specific to lumbar puncture in the pediatric patient
  • Practice obtaining informed consent for an infant lumbar puncture

 

Module: Lumbar Puncture

  • Identify relevant anatomy for performing a lumbar puncture in an infant and child
  • List equipment needed to perform a lumbar puncture taking into consideration a pediatric patient’s size
  • Understand appropriate patient positioning for a lumbar puncture
  • Demonstrate proper sterile technique
  • Perform a lumbar puncture using an infant task trainer

 

Module: Oxygen Delivery and Airway Support

  • Identify different means of oxygen delivery and understand how their use may be used to increase FiO2 delivered to patient
  • Contrast the difference between oxygen delivery and ventilatory support
  • Differentiate between non-invasive positive pressure ventilation and invasive positive pressure ventilation
  • Recognize different airway support devices and describe how they might be used in a pediatric patient

 

Module: Oxygen Delivery and Airway Support

  • Identify different means of oxygen delivery and understand how their use may be used to increase FiO2 delivered to patient
  • Contrast the difference between oxygen delivery and ventilatory support
  • Differentiate between non-invasive positive pressure ventilation and invasive positive pressure ventilation
  • Identify different airway support devices and describe how they might be used in a pediatric patient
  • Review the anatomy of the pediatric airway
  • Discuss maneuvers to open pediatric airway and adjunct devices such as oral and nasal airways
  • Discuss LMAs and their use
  • Discuss the necessary equipment for intubation

Module: Pediatric Cardiac Arrest, CPR, and Defibrillation

    • Identify apnea/absent pulses within 30 seconds of entering a room
    • Demonstrate calling for help (hit “code” button) within 10 seconds of identifying apnea or absent pulses
    • Demonstrate initiation of chest compressions within 60 seconds of entering a room in a patient without pulses
    • Describe markers of high quality CPR
    • Perform high-quality chest compressions on various task simulators
    • Describe and demonstrate proper bagging technique
    • Recognize abnormal cardiac rhythms requiring defibrillation and cardioversion
    • Compare and contrast an AED and a defibrillator
    • Demonstrate a basic understanding of PALS cardiac arrest algorithms
    • Demonstrate proficiency with using the defibrillation

 

Module: Calling a consultant

  • Identify the specific components of information needed to be given to a consultant in order to obtain expert input regarding a specific problem
  • Demonstrate eliciting recommendations for diagnostic evaluation or therapeutic management of a specific problem
  • Construct a follow-up plan for a patient

 

Module: Delivering Difficult News

  • Describe types of difficult news in the pediatric population
  • List the preparatory steps that are recommended when delivering difficult news
  • Discuss how difficult news should be delivered to families and patients
  • Practice delivering difficult news based on vignettes

 

Module: Residents as Teachers

  • Describe principles that motivate adult learning
  • Identify opportunities for ‘on the fly’ teaching
  • Practice using the One-Minute Preceptor tool in a ‘real life’ teaching scenario

Module: Parent Questions 101

  • Describe the role of anticipatory guidance in the primary care visit
  • Formulate recommendations based on common parental questions related to co-sleeping, sleep training, introduction to solid foods, pacifier use, discipline and toilet training
  • Differentiate between different stages of developmental milestones related to infants and young children

Module: Talking to Teens

  • Describe confidentiality laws by state
  • Demonstrate asking sensitive questions to teenagers
  • Construct responses and plans for next steps in management when patients make disclosures during the HEADSS assessment

Module: Social Media in Medicine

  • Identify online resources for pediatric education
    • Bedside
    • Long-term
  • Describe how to access and organize online pediatric education content
  • Examine ways to harness the power of social media for networking
  • Discuss the power of using your degree as a way to share knowledge

Module: Pain Management

  • Describe different pain control frameworks
  • Calculate equivalent doses with opioids
  • Practice building pain control plans with cases
  • Discuss disparities and harms in pain management

Module: Building Resiliency: Tools for Residency and Beyond

  • Define, recognize symptoms, and understand impact of clinician “burn-out”
  • Identify, explore, and practice tools for building resiliency throughout career

Module: Global Health

  • Identify the top 3 causes of global child mortality
  • Describe important factors that influence global child mortality (nutritional status, maternal education, access to care, etc)
  • Discuss at least one example of an effective intervention that impacts global child mortality

Module: Nutrition

  • Describe daily calorie needs for patients of different ages and with different underlying conditions
  • List basic nutritional values for commonly used formulas
  • Calculate volumes of formula needed to support growth and or maintain health

Module: Environmental Health

  • Describe the vulnerability of children to environmental toxicant exposures with a focus on lead
  • Describe resources and opportunities to improve environmental health conditions in the kids you care for
  • Address kids exposure to lead, arsenic, and preparing families for wild fire smoke in primary care.

Module: Health Disparities in Pediatrics

  • Define health disparities and social determinants of health
  • Discuss types of social determinants of health and how they lead to health disparities
  • Discuss local and national resources to get to know your patient population
  • Discuss the role of physicians in reducing health disparities

Module: Asthma

  • Perform medical stabilization of a child in status asthmaticus (Scenario 1)
  • Develop an asthma action plan (Scenario 2)
  • Classify asthma severity using the National Heart, Lung, and Blood Institute’s guidelines (Scenario 3)
  • Discuss different treatment options and management strategies for chronic asthma (Scenario 4)
  • Develop skills for effective communication with patients, families and health care providers on asthma care and management

Module: NAT

  • Formulate a differential diagnosis for an infant with altered mental status and seizure.
  • Perform medical stabilization of an infant with altered mental status and seizure.
  • Identify physical exam, laboratory, and radiologic findings concerning nonaccidental trauma.
  • Develop skills for effective communication with patients, families and health care providers on asthma care and management