Pediatric Neurology Inpatient/Consult Service - Year IV
Introduction
The neurology (pediatric and/or adult) resident in this position is the primary manager of patient care leading the pediatric intern and students. In instances when there is both an adult and a pediatric neurology resident on the pediatric neurology service, the pediatric neurology resident should assume the leadership role and should divide the responsibilities of the team. The HO-III during this rotation is expected to assume more and more a supervisory role, learn to be independent, and expand his/her neurological knowledge base pertaining to pediatric neurology. The HO-IV is expected to interact directly and independently with the general pediatric team including the attending and attend the pediatric morning report as needed.
I. PATIENT CARE
1. Interview patients more skillfully.
2. Examine patients more skillfully.
3. Improve neurological localization skills.
4. Accurately diagnose pediatric neurological disorders requiring inpatient admission.
5. Effectively manage the patient with acute neurological illness including appropriate drug therapy and non-pharmacologic treatments.
6. Define and prioritize pediatric patients' neurological and medical problems.
7. Appropriately select and interpret pertinent laboratory and imaging studies.
8. Improve technical skills like performing lumbar puncture and skin biopsy.
9. Effectively implement long-term medical care of the pediatric neurology patient.
10. Improve clinical ability to anticipate, prevent, and treat neurological complications of medical and surgical conditions.
11. Improve efficiency of care in the hospital setting.
II. MEDICAL KNOWLEDGE
1. Improve basic neurological knowledge base.
2. Expand clinical knowledge base regarding common pediatric neurologic problems requiring inpatient admission. This includes but not limited to AIDP, myasthenia gravis and exacerbation, multiple sclerosis exacerbation, acute seizures and status epilepticus, status migrainosus, meningitis/encephalitis, and stroke in children.
3. Improve understanding of evaluation and diagnostic testing for common pediatric neurologic illness.
4. Expand knowledge of potential interventions to anticipate and prevent future complications relative to the patient's illness.
5. Assess and critically evaluate current medical information and scientific evidence relevant to patient illness.
III. PRACTICE-BASED LEARNING AND IMPROVEMENT
1. Identify and acknowledge gaps in personal knowledge and skills in the care of hospitalized patients with pediatric neurological illness.
2. Develop and implement strategies for filling in gaps in knowledge and skills.
IV. INTERPERSONAL SKILLS AND COMMUNICATION
1. Communicate effectively with patients and families
2. Communicate effectively with physician colleagues at all levels, especially regarding effective written communications.
3. Communicate effectively with all ancillary care personnel involved in the care of the patient to ensure comprehensive and timely care.
4. Present patient information concisely and clearly, verbally and in writing.
5. Teach colleagues and medical students effectively.
V. PROFESSIONALISM
1. Demonstrate respect, compassion and integrity when dealing with patients and families.
2. Demonstrate sensitivity and respect for patients' age, culture, race, gender and religious beliefs.
3. Demonstrate a commitment to ethical principles of providing or withholding care, patient confidentiality and informed consent, and business practices.
4. Demonstrate a commitment to carrying out professional duties including punctuality, reliability, chart maintenance and independent learning and professional development.
5. Demonstrate professional respects for superiors, colleagues, students and all members of the health care team.
VI. SYSTEMS-BASED PRACTICE
1. Understand and utilize the multidisciplinary resources necessary to care optimally for patients in the outpatient setting.
2. Collaborate with other members of the health care team to assure comprehensive patient care.
3. Use evidence-based, cost-conscious strategies in the care of outpatients.
4. Understand the long-term consequences of patient care in relation to the individual's socioeconomic status.
Duties
1. The HO-III is directly involved in the management of all patients in the inpatient service. This includes:
· Interviewing and examining every new admission/consult.
· Composing an abbreviated admission note on every patient.
· Reviewing and guiding the interns in their performance of a complete and accurate admission history and physical on every patient.
· Leading work rounds with the intern and students.
· Assuring that the team is prepared for rounds with the attending daily.
· The pediatric neurology resident should be able to teach the adult neurology resident about the general medical care of a pediatric patient.
2. The HO-III must write a progress note on all patients. Notes must be in "SOAP" - note format and must be written in addition to a medical student note.
3. The HO-III must review all student and pediatric intern notes for accuracy and correct/amend them as necessary.
4. The HO-III will see consults in the ED or the general pediatric floors during daytime hours as directed by the pediatric neurology resident or attending.
5. The HO-III is the primary teacher for the pediatric intern and students.
6. The HO-III should personally review all CT and MRI scans of patients admitted to the service and any patients seen in consultation. Other neurologic diagnostic tests should also be reviewed by the resident.