PED 30000 Pediatrics Clerkship (Chattanooga)

PED1 Gather essential and accurate information about patients and their conditions through focused, family-centered history taking and physical examination of infants, children, and adolescents in acute, chronic, and preventive settings. 

PED2 Utilize medical knowledge and available data, including laboratory and imaging results, to create and prioritize the differential diagnosis and formulate appropriate and cost-effective management plans, including recommendations for initial orders and prescriptions. 

PED3 Document a clinical encounter in the written patient record that is accurate, organized, and displays clinical reasoning. Deliver an appropriately prioritized and audience-targeted oral presentation in a variety of clinical settings. 

PED4 Communicate effectively with members of the health care team to deliver optimal patient care. Participate in patient care transitions and handover processes. 

PED5 Demonstrate effective interpersonal and communication skills with patients and families across a broad range of socioeconomic and cultural backgrounds, including utilization of shared decision-making, education regarding normal growth and development, anticipatory guidance, as well as disease prevention and treatment. 

PED P1 Make use of self-evaluation and feedback from others to manage uncertainty, adapt to change, and develop habits of continuous improvement

PED P2 Demonstrate accountability to all patients and a commitment to carrying out professional responsibilities with integrity and compassion 

PED P3 Recognize the impact of patient care on personal well-being and identify strategies to mitigate negative effects.

 

• Consists of 3 weeks of inpatient pediatrics and 3 weeks of outpatient pediatrics. 

Inpatient

• Includes 2 weeks on the general inpatient service and 1 week of night float. 
• Students are a part of an academic team that includes an attending pediatric hospitalist, a senior resident, and 1-2 interns (pediatrics or family practice).

Outpatient 

• Includes 2 weeks in the nursery/resident clinic, the pediatric emergency department, and 1 week in a designated clinic (community pediatrics or academic subspecialty). 

Additional information regarding expectations, clinical hours, dress code, and more for each clinical area can be found in the Clerkship Handbook. 

The pediatric core clerkship is organized to align with the Core Curriculum developed by the Counsel on Medical Student Education in Pediatrics (COMSEP). Numerous learning resources are available on the COMSEP website.

To ensure students see a breadth of patients, students are required to participate in the care of at least 15 patients, representing core competency diagnosis. These case logs must be entered into Emedley. 

The clerkship utilizes Aquifer Pediatric cases to teach and test important points of clinical pediatric care. Aquifer is a comprehensive internet-based learning program with 32 interactive cases designed to cover all the core content of the COMSEP curriculum. Students are required to complete 5 cases of their choosing, though completion of additional cases is excellent preparation for the shelf exam. Aquifer cases can also be completed for core competency diagnoses if the student does not see an actual patient with a certain diagnosis during the rotation. 

Clerkship directors statewide have developed a case-based didactic series that is delivered each block at the respective campuses. Students will receive a pre-reading ahead of time and attend scheduled didactics to work through different patient cases in a small group format. Students will also attend various morning conferences sponsored by the pediatric residency program, including Board Review, General Pediatrics didactic, grand Rounds, and Morning Report. 

The curriculum incorporates additional concepts that are important in practicing pediatrics, including advocacy, humanism in medicine, and physician wellness. Additional information on the curriculum is available in the Handbook and "Assignments" section below. 

• Observed H&P - a senior resident or attending must observe each student taking a history and physical examination. This can be completed at any point during the clerkship. The corresponding form must be completed and signed in the Clerkship Handbook. 
• Clinical Skills Assessments - each student must complete 2 skills rubrics - otoscopic examination and developmental assessment. These must be directly observed by an attending or senior resident and corresponding forms must be completed in the Clerkship Handbook. These can be completed at any point during the clerkship. Supplemental materials should be reviewed (according to the handbook) prior to these assessments.
• Mid-month Feedback Form - this should be completed by an attending hospitalist after the student's first week of inpatient days. Students should complete reflection questions on the form prior to meeting with the attending for feedback. 
• Resident Evaluation of Student on Nights - this should be completed by the senior resident who works with the student on night float. 
• Nightfloat Scavenger Hunt - this should be completed by the student during four scheduled night shifts. 
• Aquifer Cases - 5 assigned cases, dude at midnight on last day of rotation. 
• Case/Time Logs - due at midnight on last day of rotation. 
• "Book Club" - this is part of the humanities and wellness curricula. Students are required to read the article "A Lovely Family"  ahead of time and consider the reflection questions. Come prepared to discuss. 
• Advocacy Project - patient advocacy is an important part of pediatrics and patient care in general. Students will complete a group advocacy project the includes the following: identification of a specific advocacy topic, 10-minute presentation of the topic to the larger group, a "one-pager" or "op-ed", and a letter to the state legislator. 

Students will be graded on a competency-based scale receiving an Honors (H), High Pass (HP), or Pass (P) on each of the three rotation-specific competencies. In pediatrics, the three competencies are Inpatient Clinical performance, Shelf Exam performance, and Outpatient/Well Baby Nursery performance.

• To receive a designation of "Honors" in the whole pediatrics rotation, students must receive Honors in all 3 competencies.
• To receive a designation of "High Pass" in the whole pediatrics rotation, students must receive a High Pass or greater in all 3 competencies.

Inpatient

• Student scores are based on the Inpatient Clinical Evaluations completed by their inpatient attending(s). An attending can work with a student ≥ 3 days to complete an evaluation. 
  • Honors = ≥ 94%
  • High Pass = ≥ 89%
  • Pass = ≥ 70%

Shelf Exam

• Student scores are adjusted by the NBME based on quarter. (Q1=0.1 clerkships completed, Q2=2-3, Q3=4-5, Q4=6
  • Honors = ≥ 75%
  • High Pass = ≥ 55% 
  • Pass = ≥ 5%

Outpatient/Well Baby Nursery 

• Student scores are based on the Outpatient Clinical Evaluations completed by their outpatient preceptor and nursery attending.
  • Honors = ≥ 92%
  • High Pass = ≥  88%
  • Pass = ≥ 70%

Links/Documents

1. Clerkship Handbook 
2. Assignments 
3. Conferences 
4. Multimedia Teaching Resources - COMSEP 
5. Aquifer - Virtual Patient Cases 
6. UTHSC College of Medicine - Memphis Pediatric Clerkship Webpage

Other Information

• Orientation Location: Massoud  140
• Pre-requisites:  Satisfactory completion of the first two years of medical school and passing USMLE Step 1
• Size:  6
• Length:  6 weeks (3 weeks inpatient and 3 weeks outpatient)
• Blocks Offered:  All
• Overnight Call and/or Float:  Yes
• Time Off for Interviews:  No
• Deadline for Excused Absence:  Thirty days before the start of the clerkship
• Deadline for Cancellation:  Thirty days before the start of the rotation

This is a face to face clinical rotation receiving 9 credit hours.