Welcome!

Welcome to the R1 Outpatient Pediatrics Rotation at CCHMC! During the month, your focus will be on routine outpatient pediatric patients including WCC and acute illness. Because of the high volume of just peds, you should be able to further develop your ‘routine scripts’ for parents along with catching abnormal physical findings we always search for but rarely ever see. This rotation uses Bright Futures extensively and I recommend you spend time during the first week to really review the resource. you can purchase this book off Amazon or borrow from another resident. Bright Future’s Pocket Book to buy.

To help with meeting the educational goals goals, we have required KSA’s (previously called SAMS or Module II’s) and Dermatology learning Modules. The Derm modules will have a powerpoint along with an associated quiz. They are relatively quick to do and actually pretty fun. The links are below. As you remember from your prior KSA's, they are quite challenging and it is normal to get only about 25% of the questions correct, but the real learning in the process is returning to the question and re-answering them. Prior to asking you to repeat the question, the site will give you the information in a concise format and ask the question again. I recommend you sit down and do the entire exam at the beginning of the month and then spend 1-2 weeks returning to it and getting the correct answers. You do not need to complete the patient simulation.

Unlike inpatient peds and emergency medicine peds, there is no need to track a total number of encounters this rotation.

You will receive an intro email from the CCHMC chief prior to your rotation. Please let Dr. Putnam know if you do not receive this.

EPIC Training

  • You will be contacted prior to the rotation to complete additional EPIC / EMR training. Please reach out to Dr. Putnam or Holly if you do not receive. Please complete this no later than 2 days prior to the rotation or else rotation will need to be rescheduled

Requirements

  • Completion of KSAs (previously called SAMS) on the ABFM website. Please send screen shot of completion of each to Dr. Putnam.

    • Care of Children

  • Dermatology Modules: Please complete the AAD Dermatology Modules on common pediatric conditions. Go to this site: Basic Dermatology Curriculum (aad.org) and create a log in. This is free. After you create a login, please return to this page to directly access the modules. Select “Basic Dermatology Curriculum” and then select “two week rotation.” The webpage can take a while to download the first time you access the module, so be patient. Each module will have slides, videos (some do not), and a quiz. Click through the menus to find the following topics. Please send screen shot of completion of each to Dr. Putnam.

  • Not required but great to review

    • Community Practice Support Tools: This is a great resource for CCHMC guidelines on common diagnoses.

      https://www.cincinnatichildrens.org/professional/resources/community-practice-support-tools

Goals and Objectives

Medical Knowledge

  • List age-appropriate screening interventions such as lead levels, anemia, hearing/vision screening. Intern

  • Describe age-dependent immunization schedule utilizing POC resource tools. Intern

  • Describe age-appropriate anticipatory guidance from infancy through adolescence. Intern

  • Review developmental milestones and tools for assessing for developmental delays and learning disabilities. Intern

  • Describe the diagnosis and treatment of the common medical problems of infants and children. Third Year

Patient Care

  • Elicit an age appropriate history including assessing for developmental stage, concerns of parents/caregiver, and any social factors that could impact the health of the patients. Intern

  • Perform an age-appropriate complete physical exam including accurately utilizing growth charts. Intern

  • Demonstrate appropriate history and physical exam for signs and symptoms of child abuse (physical, emotional, sexual, etc). Third Year

  • Administer and interpret any developmental screening tests or behavioral questionnaires as clinically indicated. Intern

  • Perform supervised procedures such as hearing/vision screening, pneumatic otoscopy, cryotherapy for cutaneous lesions, etc. Third Year

  • Initiate appropriate work up and treatment of common ambulatory pediatric conditions. Third Year

  • Appropriately triage patients who can be successfully treated for acute conditions in the outpatient setting and who warrants more intensive monitoring and subsequent referral to an emergency department. Intern

  • Assess and address adolescent specific health risk factors (including sensitive topics such as substance use and sexual activity) and social concerns including well-being at home, at school, and among peers. Third Year

Interpersonal and Communication Skills

  • Lead a discussion with the patient’s parent/caregiver around age- appropriate anticipatory guidance. Intern

  • Communicate effectively with the adolescent patient including establishing a therapeutic relationship in the context of confidentiality. Intern

  • Engage adolescent patients in conversations about healthy living and responsible decision making. Intern

Professionalism

  • Display empathy, compassion and integrity during discussion of parental/ caregiver concerns. Intern

  • Demonstrate sensitivity to the adolescent patient’s race, ethnicity, culture, language, gender, sexual orientation, gender identity and disabilities. Intern Year

  • Recognize indications for out-patient referral to pediatric specialty clinics. Intern

System Based Practice

  • For continuity patients from the Family Medical Center who are admitted to the hospital, residents are expected to visit the patient and family at some point during the hospitalization and to document the encounter. Intern

  • Develop treatment plans for adolescent patients utilizing local, state and federal agencies and resources. Third Year