Pediatrics Core Rotation
Assessment
Mid-Rotation Assessment
Mid-Rotation Assessment
Domains assessed: Fund of Knowledge, Knowledge Integration, History taking, Clinical Examination, Clinical Management, Learning Skills, Communication Skills, Professional Responsibility and Integrity, Pursuit of Excellence and Insight, Personal Interactions. Essential Clinical Encounters review.
Curriculum Block
Clerkship / Pediatrics Rotation
- Indicates most relevant
Objectives
Clerkship Objectives
- Recognise and respond to ethical issues encountered in clinical practice.
- Demonstrate clear, legible, and accurate ‘doctors orders’ (such as investigations, medication orders and outpatient prescriptions).
- Demonstrate organised, complete, informative, legible, and accurate written/electronic information related to clinical encounters (such as: admission histories, progress notes, and discharge summaries).
- Acquire and synthesise relevant information from relevant sources including: family, caregivers, and other health professionals.
- Demonstrate a patient-centred and family-centred approach to communication which requires involving the family and patient in shared decision making, and involves gathering information about the patients’ and families’ beliefs, concerns, expectations and illness experience.
- Communicate using open-ended inquiry, listening attentively and verifying for mutual understanding.
- Demonstrate communication skills that convey respect, integrity, flexibility, sensitivity, empathy, and compassion.
- Recognise factors such as fatigue, stress, and competing demands/roles that impact on personal and professional performance. Seek assistance when professional or personal performance is compromised.
- Balance personal and professional responsibilities to ensure personal health, academic achievement, and the highest quality of patient care.
- Recognise the principles and limits of patient confidentiality as it pertains to paediatrics (age of consent, emancipated minors, disclosure of suicidal/homicidal intent, and disclosure of abuse).
- Fulfil legal obligations as they pertain to paediatric practice (reporting child maltreatment).
- Demonstrate organised, complete, informative and accurate information in verbal patient presentations.
- Demonstrate a commitment to perform to the highest standard of care through the acceptance and application of performance feedback.
- Demonstrate professional behaviours in practice including: honesty, integrity, commitment, compassion, respect and altruism.
- Assess for sexual maturity rating (Tanner staging)
- Examine external genitalia
- Palpate femoral pulses
- Assess for scoliosis
- Assess the lumbosacral spine for abnormalities
- Perform infant hip examination
- Elicit primitive reflexes
- Develop management plans that demonstrate due attention to discharge planning, and recognition of key community resources to support the family once out of hospital.
- Demonstrate effective teaching/learning strategies and content that facilitate the learning of others (peers, patients, families, allied health professionals).
- Demonstrate integration of new learning into practice.
- Apply the principals of critical appraisal of the literature to guide evidenced based patient care.
- Engage in self-assessment through reflective practice.
- Engage in self-directed lifelong learning strategies.
- Identify barriers that prevent children from accessing health care including: financial, cultural, and geographic.
- Identify determinants of health for paediatric populations and the physician’s role and points of influence in these issues.
- Identify emerging and ongoing issues for paediatric patients who are potentially vulnerable or marginalised including: First Nations Peoples, new immigrants, disabled children, children living in poverty, and children with mental health, sexual orientation, or gender identity concerns.
- Engage in advocacy, health promotion and disease prevention with patients and families including: mental health, child maltreatment, healthy active living, safety, and early literacy support.
- Inspect for dysmorphic features
- Demonstrate a rational approach to finite resource allocation in patient management; apply evidence in cost-effective care.
- Employ information technology to maximise patient care.
- Demonstrate priority setting, and time management skills that balance patient care, academic responsibilities, and personal well being.
- Effectively work with other health professional to prevent, negotiate, and resolve inter- and intra-professional conflict.
- Effectively collaborate/consult/participate with members of the inter- and intra-professional team to optimise the health of the patient/family.
- Demonstrate understanding of roles and responsibilities in an inter-professional health care team; recognising his/her own responsibilities and limits.
- Work effectively, respectfully, and appropriately in an inter-professional healthcare team.
- Acknowledge/demonstrate the principals of dealing with challenging communication issues including: obtaining informed consent, delivering bad news, disclosing adverse medical events, and addressing anger, confusion, and misunderstanding.
- Respect patient confidentiality, privacy and autonomy.
- Development / Behavioural / Learning Problems: Attention deficient disorders, Autism spectrum disorder, Cerebral palsy, Fetal alcohol spectrum disorder, Global delay, Gross motor delay, Learning disability, Speech / language delay
- Lymphadenopathy: Cervical adenitis, Lymphoma, Mononucleosis, Reactive
- Limp / Extremity Pain: Bone tumor, Growing pains, Juvenile idiopathic arthritis, Legg Calve Perthes disease, Osgood Schlatter disease, Osteomyelitis, Post-infectious, Reactive arthritis, Rheumatic fever, Septic arthritis, Slipped capital femoral epiphysis, Transient synovitis, Trauma / injury
- Inadequately explained injury (Child abuse): Abusive head trauma, Domestic violence, Neglect, Physical abuse, Sexual abuse
- Headache: Brain tumor, Concussion, Increased intracranial pressure, Migraine
- Growth Problems: Constitutional delay, Failure to thrive, Familial short stature, Obesity, Turner syndrome
- Genito-urinary Complaints (hematuria, dysuria, polyuria, frequency, pain): Balanitis, Enuresis, Phimosis, Testicular torsion, Vesicoureteral reflux, Vulvo-vaginitis
- Fever: Different age groups (<1mo, 1-3 mo, >3 mo), Kawasaki disease, Meningitis, Occult bacteremia /sepsis, Urinary tract infection, Viral
- Eye Issues: Absent red reflex , Amblyopia, Conjunctivitis, Normal vision development, Periorbital / orbital cellulitis, Strabismus, Visual changes
- Edema : Nephritic syndrome, Nephrotic syndrome, Renal failure
- Diarrhea: Celiac disease, Cow’s milk protein allergy, Gastroenteritis, Hemolytic uremic syndrome, Inflammatory bowel disease, Toddler’s diarrhea
- Mental Health Concerns: Anxiety, Depression, School refusal, Suicidality
- Dehydration: Hyponatremia / hypernatremia, Mild / moderate / severe dehydration
- Bruising / Bleeding: Hemophilia, Idiopathic thrombocytopenic purpura, Leukemia
- Altered LOC: Encephalitis, Head Injury, Hypoglycemia, Metabolic disease
- Adolescent Health Issues: Disordered eating, Psychosocial history (HEADDSS), Pubertal development, Sexual health, Sexually transmitted infections, Substance use and abuse
- Acutely Ill Child: Acute abdomen, Burn, Diabetic ketoacidosis / Diabetes mellitus, Meningococcemia, Poisoning / intoxication, Shock, Trauma
- Abdominal Pain & Abdominal Mass: Appendicitis, Constipation, Functional, Neuroblastoma, Ovarian torsion, Pregnancy, Wilm’s tumor
- Demonstrate an approach (the generation of a differential diagnoses, appropriate initial diagnostic investigations, and management plan) to the following core clinical paediatric presentations:
- Recognise an acutely ill child.
- Describe differences between the medical management of paediatric patients versus adult patients.
- Vomiting: Gastroeosphageal reflux / Gastroeosphageal reflux disease, Intestinal atresia, Intussusception, Malrotation/volvulus, Pyloric stenosis
- Perform otoscopy
- Perform red reflex and cover-uncover test
- Palpate for fontanelles and suture lines
- Measure and interpret vital signs
- Measure and interpret height, weight, head circumference (including plotting on growth curve and calculation of body mass index)
- Position and immobilise patient for certain physical exam skills
- Demonstrate competence with the following paediatric physical examination skills in addition to general physical examination skills:
- Demonstrate physical examination skills that reflect consideration of the clinical presentation as well as the comfort, age, development, and cultural context of the infant, child, or adolescent.
- Well Child Care (newborn, infant, child) : Anticipatory guidance, Circumcision, Crying / colic, Dental health, Discipline / Parenting, Growth – Head circumference, Height, Weight, Body mass index, Health active living, Hearing, Hypertension, Immunizations Injury prevention, Normal development, Nutrition & Feeding, Sleep issues, Social-economic / cultural / home / environment, Sudden infant death syndrome
- The student is able to demonstrate proficiency in acquiring a complete and accurate paediatric history with consideration of the child’s age, development, and the family’s cultural, socioeconomic and educational background.
- Sore Throat / Sore Mouth: Dental disease, Oral thrush, Peritonsillar abscess, Pharyngitis, Retropharyngeal abscess / cellulitis, Stomatitis
- Sore Ear: Otitis externa, Otitis media
- Seizure / Paroxysmal event: Arrhythmia, Breath-holding spell, Brief resolved unexplained event, Febrile vs. non-febrile seizure, General vs. focal seizure, Status epilepticus, Syncope
- Respiratory distress / Cough: Anaphylaxis, Asthma, Bronchiolitis, Congestive heart failure, Croup, Cystic fibrosis, Epiglottitis, Foreign body, Pertussis, Pneumonia, Status asthmaticus, Tracheitis
- Rash: Acne, Cellulitis, Diaper rashes, Drug eruption, Eczema, Henoch Scholein purpura, Impetigo, Scabies, Scarlet fever, Seborrhea dermatitis, Urticaria, Viral exanthems
- Pallor / Anemia: Hemoglobinopathies, Hemolysis, Iron deficiency
- Newborn: Abnormal newborn screen, Birth Trauma, Congenital infections, Cyanosis, Depressed newborn, Hypoglycemia, Hypothermia, Hypotonia / floppy newborn, Large for gestational age , Neonatal abstinence syndrome, Newborn physical exam (normal, abnormal), Prematurity, Respiratory distress, Sepsis, Small for gestational age, Trisomy 21, Vitamin K deficiency
- Neonatal Jaundice: Biliary atresia, Breast feeding jaundice, Breast milk jaundice, Hemolytic anemia, Kernicterus, Physiologic
- Murmur: Congenital heart disease, Innocent murmur
Tags
Curriculum Block
Clerkship
Pediatrics Rotation
Discipline
Pediatrics
McMaster Program Competencies
3.1 Solicit and respond to feedback from peers, teachers, supervisors, patients, families, and members of health care teams regarding one’s knowledge, skills, attitudes and professional behaviours
3.2 Integrate feedback, external measures of performance and reflective practices to identify strengths, deficiencies, and limits in one’s knowledge, skills, attitudes and professional behaviours
3.3 Set learning and improvement goals
8.2 Practice flexibility and maturity in adjusting to change with the capacity to alter one’s behaviour
8.3 Develop the ability to use self-awareness of knowledge, skills, and emotional limitation to seek help appropriately
8.4 Demonstrate awareness and acceptance of different points of view
MeSH
Clinical Clerkship [I02.358.399.450.110]
Pediatrics [H02.403.670]
