PEDU-4019 - Pediatric Neurology

PEDU-4019 - Pediatric Neurology

Elective Title: Pediatric Neurology
Course Number: PEDU-4019
Elective Type: clinical Duration/Weeks: 4 Max Enrollment: 1
Prerequisites: Successful completion of Year 2
Additional Requirements: N/A
Responsible Faculty Director: Pamela Lupo, MD Periods Offered: 1-13 including holiday period 8 
Coordinator: Tiffany Swain Other Faculty:
Location to Report on First Day:
Bay Colony clinic (2785 Gulf Fwy S, 2nd floor), Neurology team room. Please contact instructor by email at pjlupo@utmb.edu one week prior to start of course

Goals
Understand the specialty of Pediatric Neurology, including the requirements for training, common problems and treatment, and interactions with other specialties. The student should begin to develop skills to evaluate patients with neurologic
complaints independently, such as performing the history and physical, following up lab tests and imaging, and coordinating with other teams.

Objectives
By the end of the rotation, students should be able to:
1. Perform and document a complete neurologic examination on a child of any age (infancy through adolescence).
2. Obtain appropriate history for patients with common neurologic complaints such as seizure or headache, while also learning pertinent questions for less common complaints.
3. Understand the broad principles in evaluation and management of children with neurologic complaints with a goal to develop a differential diagnosis and initial plan of care.
4. Determine the necessity for ordering common neurologic tests such as MRI, EEG, etc and how to incorporate the results into the patient's treatment plan. Students will also understand the risks and benefits of testing. Students may also gain experience in interpreting the tests (reading EEGs and brain MRIs) if they are interested.
5. Appreciate the social and emotional impact of neurologic diagnoses and learn techniques to communicate with patients and families in a clear and supportive manner.

Description of course activities
Dedicated clinical experience in pediatric neurology, including mainly outpatient, but also inpatient, experiences and independent learning outside of clinical duties.
Outpatient activities - 24-30 hours per week of direct patient care activities. The students are expected to work independently or with a resident to obtain the relevant history and physical examination and present the information to
faculty. The student will go in with faculty for the remainder of the patient visit including recommendations and counseling.
Inpatient activities: If there are inpatient consults at the Galveston or Clear Lake hospital, the student will have the same responsibility.
On days without clinic, the student will have the opportunity to shadow other pediatric specialties or participate in independent study.

Type of students who would benefit from the course
Those interested in a career in pediatric neurology, general pediatrics, medical genetics, developmental pediatrics, child psychiatry, adult neurology, or any related field.

    Weekly Schedule
          Estimated Course Activities (Start-Time/Finish-Time):
Day of Week   AM   PM
Monday 7:45-11:45 12:30-4:30
Tuesday 7:45-11:45 7:45-11:45
Wednesday 12-5
Thursday 8:20-12:00 1-5
Friday 8:00-11:45 12:30-4:30
Saturday
Sunday

 Average number of patients seen per week: 4-6 patients per clinic day, occasional inpatient
 Call Schedule: N/A

Research / Other Course Activities
(estimated schedule)
Activity Hours per Week
Faculty Contact-Time 32
Self-Directed Study 8
Data-Collection/Analysis
Other


Method of Student Evaluation
1.  Clinical Observation
  A. Where are students observed on this elective?
    Inpatient Service   Ambulatory   Surgery   Standardized patients
Patients simulators   Other
  B. Frequency - How often are students observed clinically?
    Daily in clinic
  C. Format - What method(s) are used to document the student's clinical performance?
    Daily oral feedback   End of period oral feedback   Written feedback
Other

2.  Oral Presentation
  A. Audience - To whom does the student present?
    Faculty
  B. Frequency / Duration of Presentation(s)?
    1. Daily presentations, generally 4-5 patients per day. Each presentation 10-30 minutes. 2. Student will present a critical evidence-based appraisal of an article (chosen by the student with faculty input) approximately once per week during the rotation
  C. Format - What guidelines are set for the student's presentation?
    Oral presentations with or without supporting material per the student's discretion
  D. Assessment - Who assesses the student's presentation performance?
    Self-assessment   Peer assessment   Faculty assessment
  E. Method of content selection
    Current cases  Student-selected topic   Assigned topic

3.  Written Assignment (H&P's, notes, papers, abstracts, etc.)
  A. Frequency of written assignment(s)?
    Written notes for clinic patients daily
  B. Format - What guidelines are set for the student's written work?
    H&P or SOAP note format
  C. Length of written assignment(s)?
    Abstract   Annotated bibliography   1 - 2 page paper   3+ page paper
  D. Are recent references required?   No    If yes, how are they selected?
   
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
    Related to patients and/or student-selected
  F. Audience - Who assesses the student's written performance?
    Peer Assessment     Faculty Assessment     Other

4.  Examination
  Format
    Oral   Written multiple choice   Written essay / short answer   OSCE
Other

5.  Extra Course Activities
  What expectations do you have for the student to demonstrate participation in the elective (e.g. small group activities, seminars, thoughtful questions, providing resources, journal club, resident lecture attendance)?
    Consistent and prompt attendance in clinic, selecting patients and performing clinical duties, writing clinic notes, participating in inpatient consults if time allows, thoughtful questions and reviewing current guidelines/treatments of common problems.

6.  Additional Costs
  Please list any additional costs and/or purchases (books, materials, movies to watch, etc.) that are required for this course. Include an estimated total cost. If there are no additional costs, please enter "None".
    None, although they should bring a reflex hammer and tuning fork to clinic

7.  Other Modes of Evaluation
  Please explain below.
    The final evaluation will be based on input from all who have interacted with the student, with special consideration of the following criteria: interaction with patients and families, teamwork, quality of oral presentations and written notes, responsiveness to feedback and improvement over the rotation, demonstration of initiative in continuous learning and patient care.
I am often able to provide letters of recommendation or reference to students who perform well in the elective

8.  If this course is an Acting Internship, please complete the following:
  A. Objectives for the AI should relate directly to the Entrustable Professional Activities (EPAs). Each AI should describe how the four key Year-4 EPAs that our school has identified as being Year-4 skills are assessed. The Year-4 objectives are:
1. Entering and discussing orders/prescriptions.
2. Give or receive patient handover to transition care responsibility.
3. Recognizing a patient requiring urgent or emergent care and initiating management.
4. Obtaining informed consent for tests and procedures.
Specify how the student will be given formative feedback on their clinical skills.
   
 
B.
Year-4 students should demonstrate mastery of EPAs they developed in the clerkship year, including recommending and interpreting common diagnostic and screening tests, and performing general procedures of a physician. They should be able to demonstrate masterfully and independently skills they mastered in Years 2-3, including efficiently performing comprehensive admission-notes and succinct daily progress notes and perform accurate, concise, and hypothesis-driven clinical presentations, form clinical questions and retrieve evidence to advance patient care. They should be able to demonstrate basic understanding of and beginning mastery of collaborate as a member of the interprofessional team and identify system failures and contribute to a culture of safety improvement.

List advanced clinical skills that a student will be assured an opportunity to practice.
   
 
C.
How specifically will this AI build on developing skills from the clerkship year to prepare students for internship?
   
 
D.
What opportunities will typically be available to all students who take this AI (procedures, required presentations, etc.)? What opportunities may be available based on patient load/presentation or student initiative (ie. Writing a case report)?
   
 
E.
An AI should have expectation of a minimum of 32 hours per week of clinical responsibilities. Duty hours should be capped at ACGME limits for an intern, thus up to 24 hours followed by 4 hours of activities related to patient safety, education, and handoff. Students cannot work more than 80 hours per week averaged over 4 weeks. They can only have 1 day off in a 7-day work week with 8 hours off between shifts.

Clinical responsibilities will vary depending on specialty, but how is the student functioning with work commensurate to a PGY1 with an appropriate level of training?
   
 
F.
How is the student demonstrating drawing clinical conclusions and/or developing a management plan and documentation as an intern would do?
   
 
G.
How and by whom will midpoint feedback be provided to the student? How will you remediate deficiencies identified at midpoint?
   
 
H.
Acting Internship students often seek letters of recommendation following their experience. How many different Faculty will work directly with the student and have knowledge of the student's abilities to detail in a written evaluation? Describe the degree of supervision and interaction with faculty vs. residents or other providers and how feedback will be obtained if more direct work is with residents or other providers.