PEDU-4010 - Pediatric Cardiology

PEDU-4010 - Pediatric Cardiology

Elective Type: clinical
Pediatric Cardiology
Course Number
Prerequisites: Successful completion of Year 2 
      Additional Requirements:
Prior meeting with course director required to discuss student and faculty expectations.
Responsible Faculty Director:
Ashraf Aly, MD, PhD
Other Faculty:
Amyn Jiwani, M.D.
Location to Report on First Day
Pediatric Cardiology Clinic at Clear Lake.
Periods Offered
including holiday period 8
Maximum Enrollment

Students will be advised to review the cardiology chapter in core concepts of Pediatrics. Basic understanding of the normal hemodynamics of the heart and in different congenital heart diseases. Develop basic skills for examining children with different cardiac problems in various age groups. Specifically, students should become comfortable and familiar with heart sounds and murmurs and should become capable of differentiating normal from abnormal heart sounds. Students should develop skills of interpreting Pediatric EKG's, chest X rays and echocardiograms of children at different ages.

This is mostly a hands on experience with direct contact with patients.
1. Take appropriate history and physical examination.
2. Interpret EKG's and chest X-rays
3. Come-up with a list of differential diagnosis
4. Participate in performing and interpreting echocardiograms
5. Understand the pathophysiology of different cardiac lesions
6. Shadow the faculty in discussing the patient's findings and management plans with the family.

Description of course activities
Outpatient Activities: We have outpatient clinics M-F in Clear Lake and Tuesday at PCP in Galveston. The students are expected to see the patients first, get H&P, interpret the EKGs, CXR and present the data to the faculty. He/she will shadow the faculty in the final patient management. Inpatient Activities: The students will do the same for the inpatient consults when there are inpatient consults.

Type of students who would benefit from the course
Students who have interest in general or pediatric cardiology. Students who are interested in general pediatrics or other pediatric specialties are also welcome. It is recommended to have some pediatric experience prior to the rotation. Typically, this elective is suitable for third and fourth year medical students.

Weekly Schedule
  Clinical Activities (estimated schedule)
  Day of Week AM PM
  Monday 8:00 a.m. 5:00 p.m.
  Tuesday 8:00 a.m. 5:00 p.m.
  Wednesday 8:00 a.m. 5:00 p.m.
  Thursday 8:00 a.m. 5:00 p.m.
  Friday 8:00 a.m. 5:00 p.m.
  Saturday -- --
  Sunday -- --
   Average number of patients seen per week: 40  
   Call Schedule:   published upon enrollment  

Research Activities (estimated schedule)
Activity Hours per Week
Faculty Contact-Time
Self-Directed Study

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?
    The students see the patients firsthand, present their findings and shadow the faculty conducting his/her evaluation. The faculty will ask the student to elicit the physical findings if there is any discrepancy. Students will be given constant feedback by the faculty and another formal feedback halfway through the rotation.
  C. Format - What method(s) are used to document the student's clinical performance?
    Daily oral feedback   End of period oral feedback   Written feedback

2.  Oral Presentation
  A. Audience - To whom does the student present?
    The student is required to present one topic per week.
  B. Frequency / Duration of Presentation(s)?
    15 - 20 minutes
  C. Format - What guidelines are set for the student's presentation?
    oral/power point presentations
  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)?
    at least once in 2 weeks
  B. Format - What guidelines are set for the student's written work?
    the student writes a complete H & P for a case they saw in the clinic
  C. Length of written assignment(s)?
    Abstract   Annotated bibliography   1 - 2 page paper   3+ page paper
  D. Are recent references required?   Yes    If yes, how are they selected?
    Core Concepts of Pediatric Cardiology
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
  F. Audience - Who assesses the student's written performance?
    Peer Assessment     Faculty Assessment     Other

4.  Examination
    Oral   Written multiple choice   Written essay / short answer   OSCE

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)?
    Students are encouraged to participate in all resident activities including their seminars, journal club and grand rounds. They are expected to attend morning reports by telemedicine every day.

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".

7.  Other Modes of Evaluation
  Please explain below.
    1. Two written H&P's
2. Three oral presentations
3. Clinical proficiency
4. Knowledge
5. EKG interpretations
6. Attitude, willingness to work and seek knowledge, motivation and attendance
7. Professionalism

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.

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.

How specifically will this AI build on developing skills from the clerkship year to prepare students for internship?

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)?

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?

How is the student demonstrating drawing clinical conclusions and/or developing a management plan and documentation as an intern would do?

How and by whom will midpoint feedback be provided to the student? How will you remediate deficiencies identified at midpoint?

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.