PEDU-4012 - Pediatric Endocrinology

PEDU-4012 - Pediatric Endocrinology

Elective Title: Pediatric Endocrinology
Course Number: PEDU-4012
Elective Type: clinical Duration/Weeks: 4 Max Enrollment: 1
Prerequisites: Successful completion of Year 2
Additional Requirements: Successful completion of Pediatric Clerkship. C-form is required to enroll, send to Tiffany Swain at trswain@utmb.edu.
Responsible Faculty Director: Phillip Lee, MD Periods Offered: 1-13 including holiday period 8 
Coordinator: Other Faculty: Chanthu Pillai, MD
Location to Report on First Day:
Contact Ped Endo office (23365) before first day to confirm reporting location.

Goals
To provide a basic understanding of the diagnosis and management of common endocrine disorders in infants, children, and adolescents.

Objectives
Upon completion of the elective, the student should be able to: 1. To accurately measure height, weight and head circumference 2. To include an assessment of growth in the work-up of all patients. 3. To explain the effective and appropriate use of growth charts in the longitudinal evaluation of height, weight and head circumference. 4. To recognize abnormalities of growth that warrant further evaluation, such as crossing percentile lines on a growth chart, significant discrepancies between height, weight and head circumference, short stature, failure to thrive, obesity, microcephaly and macrocephaly. 5. To recognize normal variants of growth such as familial short stature and constitutional delay. 6. To outline the initial evaluation of a child with failure to grow. 7. To identify, explain the pathophysiology and provide the appropriate management, both acute and long term, of diabetes mellitus type 1 and 2. 8. To recognize, diagnose, describe the pathophysiology and provide the management of exogeneous obesity, endocrine and genetic causes of obesity. 9.To identify, explain the pathophysiology of and provide for the management of hypoadrenalism and congenital adrenal hyperplasia. 10. To list, identify, treat and explain the pathophysiology of hypothyroidism and hyperthyroidism. 11. To recognize, diagnose describe and manage transient hypocalcemia in the newborn, and types of rickets. 12. To describe the normal variants of pubertal maturation, and the appropriate treatment of early and delayed puberty.

Description of course activities
1. Attend pediatric endocrinology and diabetes clinics each weekday and actively participate in the evaluation of patients.
2. Participate in the performance of inpatient consults.

Type of students who would benefit from the course
Students interested in acquiring an understanding of the endocrine basis for evaluation of growth and development disorders in pediatrics.

Weekly Schedule
  Clinical Activities (estimated schedule)  
Day of Week   AM   PM
Monday 8:30 5:00
Tuesday 8:00 5:00
Wednesday 8:00 5:00
Thursday 8:00 5:00
Friday 8:00 3:00
Saturday N/A N/A
Sunday N/A N/A

 Average number of patients seen per week: 20
 Call Schedule: N/A

Research Activities (estimated schedule)
Activity Hours per Week
Faculty Contact-Time
Self-Directed Study
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 during the clinic and on the wards.
  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?
    Division faculty.
  B. Frequency / Duration of Presentation(s)?
    Daily presentations, 10-20 minutes per patient. Presentations will be both oral and written.
  C. Format - What guidelines are set for the student's presentation?
    Templated endocrine evaluation forms, other verbal and written instructional materials.
  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)?
    Daily patient documentation (primarily H&Ps and chart review summaries: minimum 1 per clinic day).
  B. Format - What guidelines are set for the student's written work?
    Templated endocrine evaluation forms and other instructional materials.
  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?
    Students may be asked to summarize recent references for selected cases of interest.
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
    Case-related, faculty 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)?
    Pediatric Grand Rounds, morning report, department and division conferences and lectures.

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

7.  Other Modes of Evaluation
  Please explain below.
    Each student will receive ongoing daily feedback by division faculty members on their patient evaluations, management plans and documentation.
A global competency evaluation will be completed by a pediatric endocrinology faculty member at the end of the rotation.

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.