PEDU-4103 - Pediatric Urgent Care in Galveston

PEDU-4103 - Pediatric Urgent Care in Galveston

Elective Title: Pediatric Urgent Care in Galveston
Course Number: PEDU-4103
Elective Type: clinical Duration/Weeks: 4 Max Enrollment: 1
Prerequisites: Successful completion of Year 2
Additional Requirements: Successful completion of Pediatric Clerkship; contact faculty in advance of the course to discuss schedule.
Responsible Faculty Director: Manuela Murray, MD Periods Offered: 2-7, 9-13 excluding holiday period 8 
Coordinator: Tiffany Swain Other Faculty: Urgent Care Faculty
Location to Report on First Day:
IPUCC - 6416 Broadway, Galveston, TX 77551

Learn to manage common acute pediatric illnesses and distinguish severity of illness in children.

1. Evaluate acutely ill pediatric patients 2. Become comfortable with performing an efficient history and physical on acutely ill children, learning to focus the evaluation appropriately for the presenting problem 3. Develop diagnostic and therapeutic plans for common acute childhood illnesses 4. Learn to counsel families about care of acute pediatric problems 5. View common minor procedures in pediatrics and appreciate the difficulties inherent in performing such procedures on frightened children.

Description of course activities
1. Students will evaluate patients presenting to the Pediatric Urgent Care Center in Galveston. They will perform a focused history and physical, then present the case to faculty staffing the PUCC.
2. Students will propose diagnostic and treatment plans, and will evaluate radiographic and laboratory data related to patients.
3. Assist and possibly participate in minor procedures - examples include incision and drainage of abscesses, splinting, urethral catheterization, venipuncture, IV placement and lumbar punctures. The weekly schedule times are subject to change based on the availability of clinic sessions.

Type of students who would benefit from the course
Students interested in a career in Pediatrics, Emergency Medicine or Family Medicine would benefit from this course.

Weekly Schedule
  Clinical Activities (estimated schedule)  
Day of Week   AM   PM
Monday 1:00pm - 5:00pm
Tuesday 1:00pm - 5:00pm
Wednesday 1:00pm - 9:00pm
Thursday 1:00pm - 9:00pm
Friday 1:00pm - 5:00pm
Saturday 9:00am 1:00pm

 Average number of patients seen per week: 30
 Call Schedule: 32/h week (weekend counts as 2 shifts). Students create their own shift schedule for the month w/faculty approval.

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?
    Every patient encounter
  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?
    Faculty and/or resident staffing the PUCC.
  B. Frequency / Duration of Presentation(s)?
    Each patient encounter is presented.
  C. Format - What guidelines are set for the student's presentation?
    Standard SOAP patient presentation.
  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)?
    As much as possible, students will document in the EMR. However, if access to the EMR is limited, students will hand in one written note per day for review.
  B. Format - What guidelines are set for the student's written work?
    Standard SOAP note.
  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?
  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)?
    The student will attend Pediatric Grand Rounds, resident noon conferences and Morning Report as much as possible.

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.

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.