PEDU-4073 - Pediatric Gastroenterology

PEDU-4073 - Pediatric Gastroenterology

Elective Title: Pediatric Gastroenterology
Course Number: PEDU-4073
Elective Type: clinical Duration/Weeks: 4 Max Enrollment: 1
Prerequisites: Successful completion of Year 2
Additional Requirements: Successful completion of Pediatric Clerkship. Contact Nurse Clinician Felice Do ( prior to course to obtain welcome packet via e-mail.
Responsible Faculty Director: Annie Goodwin, MD Periods Offered: 1-5, 10-13 excluding holiday period 8 
Coordinator: Tiffany Swain Other Faculty:
Location to Report on First Day:
See Schedule Below

1. Basic understanding of the physiology of the gastrointestinal system. 2. Develop basic skills for examining children with various abdominal complaints. 3. Develop skills of interpreting abdominal X rays and identify abnormalities on endoscopy in children of varying ages. 4. Begin to develop traits of an independent practitioner such as interacting with families without an attending present, following up with consulting services, and longitudinally managing patients, & to begin to navigate the transition into residency in the near future

1. Take appropriate history and physical examination. 2. Analyze previous laboratory and radiologic workup prior to consultation. 3. Develop a thorough differential diagnosis. 4. Participate in discussion of the workup/plan. 5. Shadow the faculty in discussing the patients’ findings with the family.

Description of course activities
Outpatient Activities: We have outpatient clinics Tues, Thurs, and Fri in League City. The students are expected to see the patients first, get H&P, develop a concise presentation and present the data to the faculty. He/she will shadow the faculty in the final patient evaluation. Inpatient Activities: The students will do the same for the inpatient consults. They need to be available to participate in any patient procedures or testing including but not limited to endoscopy, H. pylori breath test, lactose breath test, and pH probes.

Type of students who would benefit from the course
Designed for students who have interest in general pediatrics or pediatric gastroenterology, developmental of behavioral pediatrics, adult gastroenterology, or child psychology. It is recommended to have some pediatric experience prior to the rotation. Typically, this elective is suitable for 3rd & 4th year medical students, but preferably 4th year students.

Weekly Schedule
  Clinical Activities (estimated schedule)  
Day of Week   AM   PM
Monday 9a-12p-VL (1st,2nd,3rd) & Consults (2nd & 4th) 1p-5p-VL (1st,2nd,3rd) & Learn Obj (2nd & 4th)
Tuesday 9am-12pm - Bay Colony 1pm-5pm - Consults
Wednesday 9am-12pm - PCP/Conferences 1pm-5pm - Short Gut Rounds
Thursday 9am-12pm - Bay Colony 1pm-5pm - Bay Colony
Friday 9am-12pm - Bay Colony 1pm-5pm - Consults

 Average number of patients seen per week: 20-30 depending on consults
 Call Schedule: None

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 finding 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 a critical appraisal of a Pedi GI article once during the rotation.
  B. Frequency / Duration of Presentation(s)?
    15-20 minutes
  C. Format - What guidelines are set for the student's presentation?
    Oral 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)?
  B. Format - What guidelines are set for the student's written work?
  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)?

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.