College of Medicine MD Curriculum

Pediatric Inpatient Acting Internship

Title of Clerkship: Pediatric Inpatient Acting Internship

Elective Year(s): Fourth-Year Elective

Department: Pediatrics

Type of Elective: Clinical

Clerkship Site: Russell J. Ebeid Children’s Hospital, 2142 North Cove Blvd. Toledo, OH 43606 Phone 419-291-8878

Course Number: PEDS 718

Blocks Available: All

Number of Students/Block: 1 student

Faculty: Dr. Rajat Kaul MD, Dr. Dustin Williams MD, Dr. Laura Leroux MD, Dr. Wendy Nelson-Brown MD, Dr. Erica Morgan MD, Dr. Regis Whiteside MD, Dr. Sara Barnett MD, Dr. Joseph Alecusan MD, Dr. Tiffany Lisk MD

Elective Description/Requirements: The student will function as an acting intern, as if he/she were an intern, supervised directly by a senior resident along with the attending physician. Student will perform histories and physicals on patients, simple procedures (IV’s, LP, and venipuncture) under supervision, write daily progress notes, and actively participate in ward rounds. A maximum of six patients may be followed at any time to allow time for formulation of patient problem lists and management planning. Each acting intern must complete two on-line modules to prepare the acting intern for his/her role as teachers of junior medical students.

Length of Clerkship: 4 weeks

Links to Core Competencies/Educational Course Objectives: At the end of this elective, the student will be able to:

1. Show sensitivity to cultural, ethnic and socioeconomic factors that affect personal and family traits and behaviors. (EPOs: MK-2, IPC-1, PB-1)
2. Obtain a medical history from a second person (usually a parent) as well as from the patient. (EPOs: PC-1)
3. Be able to discuss issues of appropriate privacy at all ages and confidentiality in older children and adolescents. (EPOs: PB-3)
4. Obtain records and interpret a relevant history that in unique to pediatrics in addition to the standard medical history. (EPOs: PC-1)
5. Modify the medical history depending on the age of the child, with particular attention given the following age groups: neonate, infant, toddler/preschool aged child, adolescent. (EPOs: PC-1)
6. Establish rapport with children of various ages in order to perform the physical examination. (EPOs: PC-1)
7. Recognize that the age of the child influences the area included in the exam as well as the order of the examination, and the approach to the patient. (EPOs: PBL-1, PC-1)
8. Perform and record a complete physical examination on an infant, child, and adolescent, including the observation and documentation of normal physical findings. (EPOs: PC-1)
9. Be able to explain on rounds and daily notes how findings have different clinical significance depending on the age of the child. (EPOs: PC-6)
10. Write a concise history and physical and daily progress notes that clearly identify the most likely differential diagnosis and therapeutic plans. (EPOs: PC-1, PC-6)
11. Work with other health professionals as members of a team in patient care. (EPOs: SBP-1)
12. Choose and effectively use the learning resources available for self-directed study. (EPOs: PBL-1)
13. Project a professional image and behave in an ethical, responsible, reliable, and dependable manner. (EPOs: PB-1, SBP-1, IPC-2)
14. Give a variety of common pediatric presentations of illness. Discuss the differential diagnosis and for each diagnosis the etiology and/or pathophysiology, natural history, presenting signs and symptoms, initial laboratory test and/or imaging studies indicated for diagnosis and plan for initial management (e.g. fever, sore throat, heart murmur, lymphadenopathy, seizures, etc.) (EPOs: MK-4)
15. Fluid Management:
    1. Be able to to describe thef daily water and electrolyte requirements for pediatric patients
    2. Explain factors which increase daily fluid requirements
    3. Describe conditions in which fluid administration may need to be restricted
    4. Describe the conditions that contribute to dehydration including the pathophysiology of hyponatremic and hyponatremic dehydration
    5. Explain the effect of pH on serum potassium levels
    6. Prescribe fluids appropriate o the clinical presentation (EPOs: MK-4)
16. Select and request appropriate tests and diagnostic procedures and write appropriate referrals to continue the investigation of patient problems in light of therapeutic goal, time, availability, and cost. (EPOs: MK-4, PC-1, PC-6, SBP-3)

Professionalism: UT/COM students will meet or exceed the institutional standards for professionalism as stated in the current Educational Program Objectives and the current Educational Course Objectives for the Sponsoring Department.

Instructional Methods:

1. Clinical case presentations/write-up
2. Inpatient rounds
3. Teaching rounds
4. Mentored technical skills practice
5. Interpretation of lab data
6. Residency conferences
7. Presentation on topic of student’s choice

Evaluation Methods:

1. Completion of Case presentation
2. Faulty/Resident observation and assessment of clinical skills
3. Attendance
4. Clinical Competency Evaluation

Prerequisites: Successful completion of required Pediatric clerkship.

Clerkship Director: Rajat Kaul, MD

Clerkship Coordinator: Joseph Osinski
Phone Number: 419-291-0377
Email: Joseph.Osinski@utoledo.edu

Special Requirements: Night Week

ECC Approved
September 2023