The student will spend time dispersed between hospital and clinic settings. Almost exclusively, mornings will be spent at the hospital and then the afternoon will be in the clinic.
Each morning, Monday to Friday, the student will come in and round on any nursery babies, up to 4 inpatients (eg 2 NICU patients and 2 inpatient patients). Teaching will occur during rounds and reading assignments will be given regarding the studentís patients. If time allows, and depending upon the attending of the day, case presentations/didactics can occur toward the later part of the morning. The student can work on CLIPP cases during any down time.
As best learning occurs through continuity, it will be ideal for the student to perform H and Pís on any new admissions and perform daily rounds on those patients until they are discharged. The student will be expected to do at least 3 formal H and P write-ups during their rotation, though less informal H and Pís will also occur as the student rounds and then presents patients on morning rounds. Formal H and Pís will include complete history and physical and include a thorough assessment write up (broad differential diagnosis and literature review summary on the diagnosis) and appropriate plan management for the patientóas per the requirement of the UW Core Pediatric curriculum.
All efforts will be made to have the student attend delivery resuscitations as well. The student will be provided with a phone or pager so that any educative admissions that come after 5 pm to 10 pm M-Th, they will be able to be directly involved in the patient care from initial presentation of the patient. Student will be free from any calls and any patient care from Friday after 5 pm until Monday AM.
Each afternoon starting at 12:45, the student will report to the clinic. The student initially will observe well child visits and later in rotation be able to do well child visits under observation by the preceptor. For sick visits or consults, if parents are in agreement, the student will go in first to do a focused history and exam. Student will take notes enough to present the patient to the attending after which the attending will go into the patient room to verify history and repeat exam and discuss assessment and plan with the family. Then student will be expected to write up one formal SOAP note a week on the sick visit patientsótotaling 6 SOAP notes due at the end of the rotation. A brief differential diagnosis will be included in the write up. A literature review for plan management is expected on each SOAP note to suggest standard of care management for the illness being cared for. The student will ask questions to their attending as they arise regarding developmental milestonesóas developmental questions will be included on the final exam.
The student should obtain a good pediatric review book (such as Pediatrics by Blueprints) to refer to during the rotation. Students will have core CLIPP cases to perform as required by all WWAMI pediatric core sites.