Pediatric Critical Care Acting Internship

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Department	Pediatrics
Course Number	PED 379
Course Title	Pediatric Critical Care Acting Internship
Course Director	Christiane Corriveau, MD; Lexi Crawford, MD
Length (Weeks)	4
When Offered	All year
Prerequisites	All core clerkships
Availability Notes	Students are required to complete one core acting internship during their fourth year. This course fulfills the core acting internship graduation requirement.
Contact Name	LaKeisha Brown
Contact Phone	202-476-3131
Contact Fax	202-476-5724
Contact Email	lcbrown@childrensnational.org
Other Contacts	Course Director Dr. Lexi Crawford (lcrawford3@childrensnational.org); Site Director Dr. Christiane Corriveau (ccorrive@childrensnational.org); Course Coordinators Wilhelmina Bradford (wcbradfo@childrensnational.org) and Olivia Winant (okwinant@childrensnational.org)
Location	Children's National Pediatric Critical Care Unit
Limit	2-3
Report	Students will be sent information prior to rotation.
Evaluation	Grading/Assessment: The Uniform Clinical Evaluation Rubric from GW SMHS constitutes 100% of the Acting Intern’s Grade: Honors: Earn an “outstanding” (5) on the Global Rating scale as described in the uniform clinical evaluation. High pass: Earn an “excellent” (4) on the Global Rating scale as described in the uniform clinical evaluation. Pass: Earn a “very good” (3) on the Global Rating scale as described in the uniform clinical evaluation. Conditional: Earn a “marginal performance, remediation suggested/required” (2) on the Global Rating scale as described in the uniform clinical evaluation. Fail: Earn an “unacceptable performance” (1) on the Global Rating scale as described in the uniform clinical evaluation. General Expectations: Following the same RIME (Reporter, Interpreter, Manager, and Educator) model used in the 3rd year clerkship while applying the competencies set out by the COMSEP/APPD Sub-I Curriculum, the 4th year student should be practicing the skills of Interpreter, Manager, and Educator with an increasing patient load. The AI should already be secure professionally (AKA “PRIME”) and as a reporter prior to starting the rotation. The PRIME model supposes that the student is taking primary responsibility for the patient, obtaining complete and detailed information while focusing histories, physicals, and oral/written communication appropriately, sharing information with a patient and family, prioritizing and organizing work effectively, anticipating what a patient will need during the course of hospitalization and communicating it during hand-offs, re-assessing patients and pursuing problems, coordinating care of the patient during hospitalization while planning for discharge, and functioning as a team player. Reporter: An AI should be able to consistently gather and clearly communicate the clinical facts on 4 of their own patients. The AI will obtain a thorough history and examination, and record the relevant objective information (such as vitals, i/o’s, labs, radiographs, studies) on presentation and throughout the hospital stay. This assumes that the AI knows what type of information would be expected or relevant for the patient’s given complaint. It emphasizes day-to-day reliability, efficiency and requires an attention to detail and baseline fund of knowledge. Interpreter: An AI should perform consistently at this level by the end of the month to earn a Pass. They should be able to characterize the active problems of their patient and interpret data while prioritizing and defending a differential diagnosis based on the collected data. Manager/Educator 1: An AI should perform consistently at this level by the end of the month to earn a High Pass. With a full complement of patients, they should be consistently making diagnostic and therapeutic plans and enacting those plans by effectively pursuing studies, managing consults, completing accurate orders and prescriptions, and when appropriate, doing procedures. Manager/Educator 2: An AI should perform consistently at this level by the end of the month to earn an Honors. In addition to above, they should be demonstrating self-directed learning, assess and apply the primary literature and actively teach others on the team and the family. Students should have the skills to care for 5 patients or more using the same RIME methodology as above. Additional Responsibilities to Earn a Pass/Full Credit for Professionalism: Learning Portfolio: Review the I-PASS module and email Dr. Crawford documentation of completion with a “take home message” from the module by the 1st Friday of the rotation. Send your supervising attending and Dr. Crawford Personal Goals & Objectives taken from the COMSEP AI objectives or self-created by the 1st Friday of the rotation. Completion of High Value Care Curriculum including pre-work, midmonth reflection paper and end of rotation reflection paper. Submit your Mid-month feedback form by the 3rd Tuesday of the rotation. Submit your 4 Structured Clinical Observations: by the final Friday of the rotation. Log all duty hours by the last day of the rotation. Inform the site director and Dr. Crawford if you foresee a possibility of violating duty hour regulations.
Description	Course Overview: The purpose of this course is to build on the medical knowledge and skills gained during the first 3 years of medical school while focusing on applied assessment and management—specifically in critically ill pediatric patients—typical to learners in post-graduate residencies. The case-based conferences, shared resident/AI conferences and simulations, and a website of resources/learning modules also allow AIs to explore subjects that will help them fully evolve to an independent practitioner. Educational opportunities are experiential within a multidisciplinary pediatric critical care team, self-directed, and with a great deal of pre-scheduled workshops and lectures. The material covered will allow attention to general, inpatient pediatric conditions. It is developmental in nature with a focus on Interpreter and Manager activities in Pangaro’s RIME framework, competency-based while promoting continuity between undergraduate medical education and the graduate medical education curriculum, and learner centered with a focus on self-directed learning and designed to address the learning needs relevant to patient care activities of a fourth-year medical student. Students completing an acting internship in the pediatric ICU should expect to be the primary provider for a variety of patients with critical illness. Additionally, each AI will complete the following: 1 week of night coverage as scheduled with their site director 2 weekend call shifts as scheduled with their site director Pediatric Critical Care AI Learning Objectives: By the end of this course, the student should be able to: Perform a complete and accurate history and exam in critically ill pediatric patients of varying ages, diagnoses, and complexity. Use sensitive and effective methods to communicate with patients, families, and staff. Interpret the value of various tests and procedures in the work-up of a hospitalized critically ill child. Practice organizing information for transition of patient care across different healthcare settings. Apply practices of evidence-based medicine to formulate an assessment and plan for critically ill children. Demonstrate the impact and inter-relatedness of developmental, emotional, socioeconomic, and organic factors as they affect the child’s health when evaluating patients and proposing diagnostic or therapeutic plans. Demonstrate the ability to manage patient care efficiently and effectively. Demonstrate the ability to assess, resuscitate and stabilize critically ill children. Demonstrate the ability to create personal short and long term plans to achieve clinical competency. Demonstrate effective oral and written case presentation skills for new patients and follow-up care. Demonstrate appropriate professional and ethical behaviors related to patients and other health care professionals.
Additional Notes