Child Health Clerkship

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Child Health Clerkship
www.ch.missouri.edu
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Organization of Rotation

• 4 weeks of inpatient care
• 2 weeks on the pediatric wards (7E and 6E)
• 1 week night float (three calls)
• Two half days of community events during night
  float week
• 1 week in newborn nursery (CRH)

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Organization of Rotation

• 4 weeks of outpatient care
• 2 weeks of general pediatric outpatient clinics
• 2 x 1 week of pediatric subspecialty clinics
• Patient centered care clinic one half day during
  rotation

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Continuity Clinic

• Each student is assigned to a half day clinic
  that will occur every week in the same day and
  time at the same location supervised by the same
  attending
• This clinic will take priority over any other
  part of the rotation
• Please check carefully and make sure there are no
  schedule conflicts (e.g. patient centered care
  and same day clinic at same time)
• Please make sure your same day clinic is aware if
  you are out of town for two weeks so they know
  not to expect you those two weeks
• For students assigned to Monday AM clinics, next
  week will be your first clinic

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Call

• Long overnight ward call
• Nursery call
• ER call

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Ward Call

• During one week each student will do three
  overnight calls from 1700 until end of resident
  check out rounds the next morning to present
  newly admitted patients
• Call is three consecutive nights
• If there are no admissions overnight the
  night-call student does not have to stay for
  check out rounds
• Night call students are not required to attend
  noon lectures unless they are scheduled for oral
  exam during week of night call
• You are expected to attend same day clinic during
  night call week

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Nursery Call

• Only when in nursery for 1 week
• Pick one week night when student will stay until
  22.00 pm
• Student will cover one weekend day to round with
  attending
• Pay attention to the last week of the rotation as
  students may switch sites over the weekend and
  not on
• Monday

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ER Call

• During 4 weeks of outpatient rotations
• Students may switch as long as changes indicated
  on paper call schedule on 7 E and Ruth Sypes
  notified of changes
• Call starts at 17.00 and ends at 22.00 on week
  days and weekend days
• Please report to pediatric resident doing ER
  rotation

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Patient Centered Care Clinic

• Each student is assigned to a patient centered
  care clinic for one half day
• Some students will leave their scheduled activity
  for half day to attend this clinic
• For some students these clinics are part of their
  rotation that week

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Community Events

• Each student will participate in at least two
  half day community events
• YOU DO NOT HAVE TO DO VOLUNTEER WORK
• Participation should happen during night call
  week
• Time can be spend during day or evening, weekdays
  or weekend
• Coyote Hill should be visited by ALL STUDENTS for
  a half day, student needs to arrange date and
  time with house parent

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Community Events

• Contact numbers are on list that is in
  orientation package
• PLEASE SCHEDULE IN ADVANCE
• Let Ruth know what events you participated in and
  what you thought of it so we can keep track of
  this, NO formal write-up is required
• There is a running list on Child Health student
  website with comments from all students last year
  regarding experience

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Educational conferences

• Problem-conference Tuesday at noon
• Once a month med-peds conference on first
  Thursday of the month at 08.00 at M437
• Grand Rounds Friday at 08.15 in Acuff
• Noon lectures or oral presentations. Weekly
  updates are provided.

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Clerkship Grade Make-up Onsite

• 20 NBME shelf exam
• 10 CLIPP exam
• 30 outpatient evaluation (attendings only)
• 30 ward inpatient evaluations (attendings and
  residents)
• 10 nursery evaluations (attending and residents)

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Other requirements to pass Child Health clerkship

• Passing score (gt50) of Oral Exam
• Attendance at all teaching conferences unless out
  of town
• Meeting the minimum patient encounter
  requirements as specifically set for Child Health
  and entering data in PLOG
• Completion of all CLIPP cases
• Participation in at least one observed History
  and Physical patient encounter (does not count
  for grade calculation)
• Completion of on-line evaluations (not able to
  sit for exam if not completed)

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American Disability Act

• Please notify the Course Director or Course
  Coordinator within the first week of the rotation
  if you have special needs to be addressed under
  the Americans with Disabilities Act (ADA). 
  Failure to notify us by the end of the first week
  of the rotation may forfeit your rights to
  request special accommodations (including but not
  limited to extended examination time
  allotments).  Reasonable effort will be made to
  accommodate special needs for which documentation
  is provided.

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Official ADA policy

• If you need accommodations because of a
  disability, if you have emergency medical
  information to share with me, or if you need
  special arrangements in case the building must be
  evacuated, please inform me or Ruth Sypes
  immediately. Please see me privately at my
  office.
• Office location Dr. Kersten N723  
• To request academic accommodations (for example,
  a note taker or extended time on exams), students
  must also register with the Office of Disability
  Services (http//disabilityservices.missouri.edu

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•  HOW TO HUG A BABY  

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First, spy a baby. 
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Second, be sure that the object you spied was
indeed a baby by employing classic sniffing
techniques. If you smell baby powder and the
wonderful aroma of wet diapers this is indeed a
baby. 
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Next you will need to flatten the baby before
actually beginning the hugging process.
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The "paw slide" - Simply slide paws around
baby and prepare for possible close-up.
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Finally, if a camera is present, you will need to
execute the difficult and patented "hug, smile,
and lean" so as to achieve the best photo quality
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PEDIATRIC WARDS

• Students will work in two teams
• Teams alternate daily in taking new admissions
• Team starts taking admissions from 0800 AM until
  1700 and picks up admissions overnight until
  0800 the following morning
• Student is not expected to do full admission on
  more than two patients per day but should be
  involved with as many admissions as possible if
  maximum of 5 patients has not been met
• Students are not expected to actively follow more
  than 5 patients

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PEDIATRIC WARDS

• Students should write full admission notes and
  progress notes on their patients by using
  Powernotes
• All notes should be forwarded to hospitalist
  attending physician
• Students should give preference to patients from
  general ward attending but can also admit and
  follow patients from subspecialists when maximum
  of 5 patients has not been met

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PEDIATRIC WARDS

• All admission notes should include Weight, Height
  and Head Circumference (under 2 years of age) and
  include on which percentile growth measurement
  falls
• Daily progress notes should include weight trends
  on all our infants as well as all children
  admitted for failure to thrive

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Ward Call

• Call starts at 1700 and ends after check out
  rounds the next morning
• Three calls in one week period
• Newly admitted patients are handed off during
  check out rounds to the student team that
  admitted during daytime previous day
• Call student is expected to present newly
  admitted patients overnight during check out
  rounds up to a reasonable amount

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Ward Call

• Call student not expected to do more than two
  full HPs during call period but should be
  involved with as many admissions as possible
• Overnight call student is not expected to write
  daily progress notes on patients the following
  morning and should go home as soon as check out
  rounds are over. Daily progress notes are the
  responsibility of the day team.
• Night call students are not expected to attend
  noon lectures unless they are scheduled for oral
  exam that week

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DAILY WARD TEAM SCHEDULE

• 600 a.m. Night float hand-off
• 700 - Intern/med student pre-round with senior
• 800 - Morning report T/W/Th
• 830 Hospitalist rounds
• 1030 Hematology/Oncology rounds
• 1215 - Conference
• 100-200 - Work time
• 500 - Check out with night floats

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Observed H P

• Each student is expected to have one observed H
  P done with form filled out by resident or
  attending
• Be pro-active about this and dont wait till last
  day
• Does not count towards grade but is used to
  provide constructive feedback so the earlier you
  do it the more beneficial it would be

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PLOG
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Unique Child Health PLOG features

• Partial participation or observed participation
  can count towards meeting requirements for
  several selected entries
• Electronic CLIPP cases can count towards meeting
  requirements for several selected entries

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PLOG General Info

• Full participation means that you obtained
  history by yourself, performed independent
  physical exam and formulated differential
  diagnoses with action plan
• Partial participation means that you actively
  participated in at least one part of the visit
  whether that is history, examination or other
  type of skill
• All entries must be made by Monday 7 a.m. of
  following week

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General Child Health PLOG rules

• For disease/symptom entries use only full
  participation encounters except for well child
  exams from 0-12 years were partial participation
  and observation is acceptable for entry as well
• For certain skill entries you can have partial
  participation when you actively participated in
  one specific element of the visit
• There are several categories for which simulated
  case entries (CLIPP cases) will count towards
  total requirements
• Well child exams occur in clinic, not in nursery
  or on wards
• Secure Login

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CLIPP
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Simulated Cases

• www.clippcases.org.
• Go to the website and follow directions for new
  users, your password will be send by E-mail
• Clerkship director has access to CLIPP and is
  able to view which cases are done, how much time
  spend on a case and what percentage of cards
  completed
• Registration fees have been paid by department of
  Child Health

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Student Evaluation of Clerkship (SEC)

• Students will receive periodic E-mails to
  electronically evaluate preceptors and lectures
• At end of rotation students will also need to
  electronically evaluate the overall clerkship
• Responses are anonymous
• Preceptors will only see pooled responses
  annually or bi-annually
• Completion of evaluations is necessary in order
  to sit for the shelf exam on last day of block

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Most Important Rules

• HAVE LOTS OF FUN and LEARN AS MUCH AS YOU CAN
  ABOUT THE HEALTH OF CHILDREN
• ACTIVELY SEEK FEEDBACK
• ASK AS MANY QUESTIONS AS YOU WANT TO
• Child Health Website Child Health