Pediatrics Clerkship Online Course Packet

Pediatrics Clerkship Online Course Packet

Goals and Objectives

The Pediatrics Clerkship will enable the student to:

    • learn a body of information about infants, children, and adolescents which will provide a foundation for their medical careers
    • foster the development of sound professional attitudes, including integrity, a commitment to patients/families, the ability to communicate clearly and effectively both verbally and in writing, and to stimulate a commitment to continuing education
    • observe skillfully and analyze the behavior of children and their families
    • develop differential diagnoses and clinical decision-making based on an accurate history and physical examination
    • continue to develop and refine habits of self-directed and life-long learning
    • communicate effectively and empathetically with children and their families, regardless of ethnic or socioeconomic backgrounds
    • utilize effective interviewing techniques necessary for obtaining an organized and complete pediatric history
    • conduct and record a thorough and accurate physical examination
    • develop accurate and complete problem lists, assessments, and plans
    • use information obtained from clinical sources (history, physical examination, laboratory, and chart) and pediatric literature to make clinical decisions
    • perform various common pediatric procedures under supervision of resident and staff
    • monitor effectively and efficiently the hospitalized patient under supervision of resident and attending physician
    • present a patient during rounds or case conferences in an efficient, organized, and thorough manner
    • describe the importance of psychosocial and environmental influences on the children and their families
    • demonstrate knowledge of the importance of effective cooperation between physicians, nurses, and other professionals, and consistently show appropriate professional conduct and appearance
    • demonstrate an understanding of the pathophysiology of common pediatric diseases

The Pediatrics Clerkship is intended to teach you to react with empathy and sound medical judgment in clinical encounters with infants, children, and adolescents. The clerkship is designed to provide basic pediatric skills and knowledge necessary for all students, regardless of the area of specialization you select. To accomplish these goals you must develop a basic understanding of normal growth and development, the influence of the environment on health, the impact of hospitalization on the child/family unit, and basic principles of common diseases affecting children.

This rotation in pediatrics will provide a continuation of the clinical education that was initiated during Essentials of Clinical Medicine (ECM). You will be expected to hone your abilities, to assess your patients, and to make clinical decisions based on your assessments.

Student Expectations and Grading

Patient Work Ups:
You will be expected to perform a complete admitting history and physical examination on your patients. In addition, you will be expected to synthesize the information obtained from the history and physical to develop an assessment and plan. Your write-up is very important as it will become a permanent part of the patient's medical record. Periodically (frequency determined by site), you will be expected to hand in write-ups which will be critiqued.

  • Elements of a Pediatric History and Physical

Patient Monitoring:
You will be expected to monitor your patients regularly, and write daily progress notes and orders under the direction of your resident.

Case Presentations:
It is important for you to begin to develop your skills at formal case presentations by presenting to your senior resident, attending physician, or at case conferences.

Discharge Letters:
Some of your patients will require a dictated discharge letter. This is the responsibility of the student. This is an important learning experience because it gives you an opportunity to crystallize your thinking about your patient.

  • Elements of a Pediatric Discharge Summary

Outpatient Care:
Some rotation sites include an outpatient experience in the clinic. When seeing outpatients you are expected to perform a brief history and physical examination, and formulate an assessment and plan. Once again, your chart write-up will become a permanent part of the patient's record; therefore, it is important for it to be organized, legible, and complete.

Written Exam:
There will be a written exam given on the final morning of the course. The exam will be the CLIPP examination, and will be administered to all students taking PEDS 7501 in the Twin Cities at a location at the University campus. You will receive an email regarding the specifics of the exam during the rotation. Due to the strict guidelines for taking the test, all students are expected to take the exam on the assigned date. There will be no call for students the night prior to the exam. 

Learning Opportunities:

Lectures
Each site has a series of educational conferences.  Students are expected to attend these conferences with their teams and/or student colleagues. 

CLIPP
The Computer-assisted Learning in Pediatrics Project (CLIPP) is a comprehensive internet-based learning program for use by medical students during their pediatric clerkship. CLIPP's interactive cases are designed to cover all of the core content of the curriculum of the Council on Medical Student Education in Pediatrics (COMSEP) and summaries following the cases can be used as a comprehensive study guide to prepare for the CLIPP exam. It is expected that each CLIPP case will take a student approximately 45 minutes to complete, so that students may work through the full learning program over the course of an average six week clerkship. This is an excellent way to supplement your learning about pediatrics during the clerkship since during a six week course there will certainly be common diseases that you just did not happen to encounter. You can follow the link and log-in with your University ID.

Reading about your patients
There is no required text for PEDS 7501.  Please use the CLIPP cases as your foundational learning materials during the clerkship.  Although no text is required, the most relevant is The Pediatric Clerkship Guide by Jerold C. Woodhead, and is available at the bookstore at Coffman Union.  Other recommended resources are listed below:

  • MD Consult - Online resource available free to students through the Bio-Medical Library where you can access these texts in Full-Text format and Journals such as Pediatrics in Review.  Given that you have access to this online, there is really no need to buy a book that will just become outdated.
  • University of Minnesota Bio-Medical Library
  • STAT!Ref - Another useful online resource that contains some online texts not available through MD Consult.
  • PDA Format: Free app download from Skyscape; a good resource because of its portability. 

Grading
Your grade will be based on:

  • Evaluations by your supervising residents and attendings - 60%
  • Your performance on the CLIPP exam - 30%
    Note: A passing grade on the CLIPP exam is 60% or above.  Failure to pass the CLIPP exam on the first attempt will automatically disqualify the student from receiving any grade higher than a 'Satisfactory' for the clerkship.  Failure to pass the CLIPP exam on the second attempt will constitute failure of the clerkship.
  • Performance based on evaluations by your site director - 10%
    This can include observation of history and physical exam, formal presentation in a conference (i.e. Morning Report), or participation in lectures/small group discussions.

To receive a passing grade for your clerkship, the following requirements must be fulfilled:

  • Passing score (60% or above) on the CLIPP exam within two attempts
  • Satisfactory clinical and professional performance, including required attendance
  • Summary clinical grade that meets or exceeds expectations (average of 2.0 or better)
  • Complete site-specific assignments
  • Returned materials (pagers, parking cards, etc.)

A grade of Incomplete 'I' will be assigned if the student does not complete the required elements of the clerkship (outlined above) and has not scheduled their completion.  A grade of Deferred 'K' will be assigned if the student does not complete the required elements of the clerkship and has scheduled their completion.

The above expectations and other personal qualities will be used as a basis for evaluation.  Finals grades will be awarded by the site director following a discussion of each student's performance.  All marginal performances will be discussed at the Pediatric Clerkship Committee meeting.  The Pediatric Clerkship Committee consists of the Course Director, the Site Director, Chief Residents, ad the Pediatric Medical Student Education Director.  Grading will be curved against historical norms to produce approximately 25% 'Honors', 60% 'Excellent', and 15% 'Satisfactory' at each site.

Clerkship failure - Failing grades can be assigned based on clinical performance, professional concerns, and two failed attempts of the CLIPP exam.

Honors - Honors grades for the Pediatric Clerkship are given to approximately 25% of students.  In addition to honors performance clinically, students must demonstrate superior knowledge through a score of 80% or higher on the CLIPP exam. 

Clinical Site Descriptions

University of Minnesota Masonic Children's Hospital
The University of Minnesota Masonic Children's Hospital is an ecologically friendly, 96-bed, 227,000 square-foot facility that consolidates in one patient and family-centered location for the hospital's 50 pediatric specialties.  The hospital, affiliated with the University of Minnesota Medical School, provides a broad spectrum of pediatric programs and services - ranging from pediatric general surgery, imaging and neonatal, pediatric intensive care, and cardiac services to oncology and blood, marrow, and organ transplantation.  Innovative approaches and affiliation with the University of Minnesota have led to several firsts, including the first successful pediatric bone marrow transplant, infant heart transplant in Minnesota and cochlear ear implant surgery for a child.  Medical students spend two of six weeks at Fairview Children's Clinic, one week on night shifts during their inpatient rotation, and three weeks on inpatient day shifts with occasional long call under the supervision of a senior resident.  The general pediatric teaching service uses bedside rounding led and facilitated by pediatric hospitalists to provide patient-centered care and education.

Children's Hospitals and Clinics - Minneapolis
Minneapolis Children's is a 163-bed, private hospital that provides a broad range of general pediatric educational opportunities for residents and students.  There are two inpatient pediatric teams, each consisting of one senior resident, junior residents, and two to three medical students accepting admissions to a teaching service.  With support from the team, students take responsibility for direct patient care.  Supervision is provided by in-house pediatric and Med-Peds hospitalists.  Schedules include a combination of day and night shifts.

Children's Hospitals and Clinics - St. Paul
St. Paul Children's is a 105-bed, private hospital with an emphasis for students and residents on inpatient care.  There are two patient care teams during the day, each consisting, on average, of one senior resident, one or two interns, and three medical students.  Community and hospital-based primary care and subspecialist pediatricians provide supervision for patient care.  Students work directly with faculty preceptors to provide ongoing care to patients and families during their hospitalization.  During their 4 weeks at St. Paul Children's, students spend 2.5 weeks working day shifts, one week working night shifts, and have a few Education Days (involving focused didactics and time to focus on CLIPP cases).

Hennepin County Medical Center
HCMC is a county based hospital with a very busy clinic and nursery area, a 7-bed Peds ICU, and 18-bed Pediatrics ward.  Students rotate through a comprehensive set of educational experiences in each of the above areas during the course of their 6-week clerkship.  Patients represent a wide diversity of cultural and socioeconomic backgrounds.  There are four teams, each consisting of one senior resident, one or two interns, and one or two medical students.  There are a few overnight call shifts built into each medical student's rotation.  The HCMC pediatricians are committed to medical student education and have a variety of interests, including: clinical research, asthma, infectious disease, child abuse, public health, and adolescent medicine, among others.

Program Contacts

Director and Administrator:

  • Director of Undergraduate Medical Education in Pediatrics
    Katherine E. Murray, MD, MPH
    (612) 626-0126
    murra057@umn.edu
  • Clerkship Director, University of Minnesota Masonic Children's Hospital
    Cindy Howard, MD, MPHTM
    drcindy@umn.edu
  • Clerkship Administrator; Site Coordinator, University of Minnesota Masonic Children's Hospital
    Sara Duxbury
    sduxbury@umn.edu

Site Contacts:

Children's Hospitals and Clinics - Minneapolis
Site Director: Molly Martyn, MD
Molly.Martyn@childrensmn.org
Site Coordinator: Alison Chandler
alison.chandler@childrensmn.org 

Children's Hospitals and Clinics - St. Paul
Site Director: Richard Andersen, MD
richard.andersen@childrensmn.org
Site Coordinator: Alison Chandler
alison.chandler@childrensmn.org  

HCMC
Site Director: Sonja Colianni, MD
sonja.colianni@hcmed.org
Site Coordinator: Lisa Loehr
lisa.loehr@hcmed.org

The University of Minnesota is committed to the policy that all persons shall have equal access to its programs, facilities, and employment without regard to race, color, creed, religion, national origin, sex, age, marital status, disability, public assistance status, veteran status, or sexual orientation.

This publication is available in alternative formats upon request.  Please Contact:

Sara Duxbury
Pediatrics Education Office
1st Floor, East Building
Room M136
2450 Riverside Avenue
Delivery Code 8950A
Minneapolis, MN 55454
sduxbury@umn.edu