UC COM :: M3/M4 Course Syllabi

M3/M4 Course Offerings

2017-2018 M3/M4 Course Syllabi

Pediatrics

COURSE NUMBER:

16 01 06

TITLE:

ADOLESCENT MED OP -ICE
This elective provides an intensive experience in the outpatient and inpatient care of adolescents with emphasis on the knowledge and skills needed to evaluate and manage both physical and psychosocial disorders in the context of biologic and psychosocial maturation.

PREREQUISITES:

26946374 (OBSTETRICS/GYN CORE CLKSP), 26961373 (PEDIATRICS CORE CLKSP)

Completion of core Pediatrics and OB/Gyn clerkships in third year.

expand all

GENERAL INFORMATION

COURSE YEAR:

CREDIT HOURS:

CREDIT WEEKS:

DOMESTIC VISITING:

YES

INTERNATIONAL VISITING:

GRADED:

Honors/High Pass/Pass/Fail

COURSE QUALIFICATIONS:

ICE, Outpatient

COURSE TYPE:

Clinical

STATUS:

Full-Time
OFFERED AS FULL-TIME AND PART-TIME: NO
ALLOWS OVERLAP: YES

COURSE LENGTH:

4 wks

DIRECTOR:

Corinne Lehmann, MD
corinne.lehmann@cchmc.org
636-8591
3244 Burnet Avenue (Kasota), 7.22

ADMINISTRATIVE SUPPORT PERSON:

Mimi Pence
Mimi.Pence@cchmc.org
636-0339
Kasota Building, 7th Floor at CCHMC, BN7.727

INSTRUCTOR:

Corinne Lehmann, MD

SITE(S):

CCHMC - Cincinnati Children's Hospital

MAX ENROLL:

ROTATIONS:

Rotation	Dates	Max
1	07/03/2017 - 07/28/2017	1
2	07/31/2017 - 08/25/2017	1
3	08/28/2017 - 09/22/2017	1
4	09/25/2017 - 10/20/2017	1
5	10/23/2017 - 11/17/2017	1
6	11/27/2017 - 12/22/2017	1
7	01/02/2018 - 01/26/2018	1
8	01/29/2018 - 02/23/2018	1
9	02/26/2018 - 03/23/2018	1
10	03/26/2018 - 04/20/2018	1
11	04/23/2018 - 05/18/2018	1
12	05/21/2018 - 06/22/2018	1

NOTE: If a rotation is offered in both 2 and 4 week slots, the max capacity is limited to the actual spots offered for the 4 weeks. (ie: the 2 week rotations listed share the max of the 4 week rotation)

WORKING HOURS:

7:30 a.m. - 5:30 p.m. Monday - Friday

REPORT 1^ST DAY:

Location C- 2nd floor Teen Health Center 7:45 a.m.

INSTRUCTION

LEARNING ACTIVITIES:

Case-Based Instruction/Learning
Clinical Experience - Inpatient
Clinical Experience - Inpatient (Nights)
Conference
Demonstration (description, performance, or explanation of a process, illustrated by examples, observable action, specimens, etc)
Patient Presentation--Learner
Research

LEARNING ENVIRONMENT POLICIES:

UCCOM strives to provide medical students with a learning environment that is conducive to their professional growth. All UCCOM and visiting medical students are encouraged to review the Student Handbook.

The Office of Student Affairs and Admissions is available to all UCCOM and visiting medical students to discuss any concerns/questions related to the learning environment. Please call 558-6796 to access faculty/staff that can assist you.

ORIENTATION:

Cindy Samuels, RN- orientation guide and other faculty

TEACHING:

60%	Attending Physician
40%	Senior Resident

FEEDBACK:

Elective director

ASSESSMENT:

FINAL GRADE:

90%	Clinical work performance evaluations
10%	Attitude, e.g., professionalism, motivation etc

GRADE ASSIGNED BY: Elective director

OBJECTIVES

Attitudes :

1. Be able to provide all pregnancy options and contraceptive counseling as a matter of routine care

2.Be non-judgmental working with patients who have substance abuse, violence, HIV infection or other STIs, and other psycho-social concerns

3. Interact with non-physician health professionals in an effective and respectful manner.

Curricular Resources :

Given on first day- orientation packet and articles posted on CenterLink- CCHMC's intranet.

Students will also be given access to an online module called ECourse which covers common adolescent topics.

Knowledge/Skills:

   1. Describe the physical and hormonal changes of puberty and their measurement.
   2. Describe the process of psychosocial development during adolescence.
   3. Recognize and describe normal variations and abnormal patterns of pubertal and psychosocial development and the appropriate methods of evaluation and management.
   4. Perform a comprehensive health, well-visit evaluation of an adolescent.
   5. Recognize and describe the pathophysiology, evaluation, and management of common health problems of adolescents including abdominal pain, acne, allergic disorders, eating disorders, growth problems, gynecologic problems, headaches, and pubertal delay.
   6. Describe the impact of chronic illness on pubertal and psychosocial maturation and specific problems of common chronic diseases in adolescents.
   7. Describe the specific problems of developmental disabilities, including learning disorders, in adolescents and approaches to evaluation and management.
   8. Identify and describe the evaluation and management of complications of sexual activity in adolescents, including contraceptive needs, pregnancy, sexually transmitted diseases, and psychosexual disorders.
   9. Identify and describe the evaluation and management of substance abuse in adolescents, including smoking, drinking alcohol, exposure to inhalants, licit and illicit drugs.
   10. Describe the application of preventive health measures to adolescents, including immunization and health education needs.
   11. Discuss problems and methods of health care delivery for adolescents including traditional settings (clinic, hospital, office) and alternative settings ( Juvenile Court, various drug and mental health treatment programs, school- based health,etc.).

Main Course Topics :

interviewing skills
  normal psychosocial development
  puberty issues
  menstrual irregularities
  contraception
  legal issues and confidentiality
  substance abuse
sports physical

sexually transmitted infections

eating disorders

mental health issues and treatment

transgender medicine

Objectives:

The Division of Adolescent and Transition Medicine of the Department of Pediatrics offers an elective in Adolescent Medicine to fourth year medical students. This elective is designed to provide in-depth experience in the outpatient and inpatient care of adolescents with emphasis on the knowledge and skills needed to evaluate and manage both physical and psychosocial disorders in the context of biologic and psychosocial maturation. The student will be exposed to current multi-disciplinary approaches to a variety of adolescent health problems including acne, allergic disorders, eating disorders, psychosomatic complaints, substance abuse, sexually transmitted diseases, pregnancy, gynecologic problems, family planning, chronic disabilities, and the assessment of common psychosocial-family problems. Regularly scheduled conferences, access to extensive resource materials and faculty supervision augment the learning experience. The duration of the elective is four weeks. We do not typically offer a two week elective experience. The elective does include one week of inpatient rounding under resident and faculty supervision. The inpatient rounding is daytime hours, Monday to Friday. Students interested in transition medicine should sign up for that elective separately.

Other Resources - Audiovisuals:

   How to perform a pap smear.
   Pubertal maturation.
   Sexual history and interviewing technique.
   Variable grand round topics are also available.

Other Resources - Computer resources:

Available for literature search and hospital laboratory results.

All syllabus materials will be available on Children's Hospital Intranet "CenterLink" site during the rotation.

Other Resources - Other :

All CCHMC imaging results are available through the EMR EPIC.

Procedures:

1. Perform a pelvic exam, including pap smear and screening for sexually transmitted infections.
2. Prepare and interpret wet prep and KOH slides of vaginal secretions.

3. Perform an appropriate genital exam of both genders, including use of a chaperone.

SAMPLE WEEK

Monday:

7:30AM	8:30AM	Teen Health Lecture
8:30AM	12:00PM	Clinic vs Inpatient Rounding
12:00PM	1:00PM	Housestaff conference or lunchtime
1:00PM	5:00PM	clinic

Tuesday:

8:00AM	9:00AM	Grand Rounds
9:00AM	12:00PM	clinic
12:00PM	1:00PM	free or peds housestaff conference
1:00PM	5:00PM	clinic

Wednesday:

7:30AM	8:30AM	Teen Health Lecture
8:30AM	12:00PM	clinic
12:00PM	1:00PM	Housestaff conference
1:00PM	5:00PM	Clinic

Thursday:

7:30AM	8:30AM	Teen Health Lecture
8:30AM	12:00PM	Clinic
12:00PM	1:00PM	Housestaff conference
1:00PM	5:00PM	clinic

Friday:

8:00AM	9:00AM	FIRMS conference or Teen Health Lecture
9:00AM	12:00PM	clinic
12:00PM	1:00PM	Housestaff conference or lunchtime
1:00PM	5:00PM	clinic

SCHEDULE NOTE:

DUTIES OF STUDENTS ON ADOLESCENT MEDICINE ELECTIVE

1. Perform comprehensive assessment of one to three new patients each week. The patients will be new to the CCHMC Teen Health Center and assigned by a precepting physician, who will discuss the evaluation and management. The student may also be assigned to see patients at the Youth Detention Center (2020), Cincinnati Job Corp location, and/or an asthma quality improvement focused clinic as spots are available. Spots are not available every month depending on the number of residents participating in their elective at CCHMC. You will need transportation to get to off-site locations.

2. See various patients for routine follow-up appointments or acute visits (call-in, walk-in). The patients will be assigned by the preceptor for the day who will directly supervise you and discuss the problems and management with you. You will write notes on your assigned patients in EPIC, our electronic medical record when at CCHMC.

3. Round on inpatient adolescent medicine patients for one week. Duties include pre-rounding, writing admission notes, progress notes, examining patients, coming up with assessments and plans. All inpatient work will be under the direct supervision of an adolescent medicine senior resident, fellow, or attending. Typically students follow 1-2 patients per day, but can follow more if skills and time permit. Inpatients are typically admitted with eating disorders, but any type of patient could be admitted to this service.

4. Attend teaching conferences held for the trainees of the Teen Health Center. These include a series of talks on common problems held at 7:30AM in the Teen Health Center. Students are also welcome to attend CCHMC residency conferences as they are invited and able to get to those conferences.

5. When indicated for patient care, give injections, perform examinations of urine and wet mounts, etc.

ATTENDANCE AND ABSENCE POLICY

Session Attendance for M4 Students

Students may miss no more than two days of planned excused absences on a four week rotation without being required to make-up the work, at the discretion of the clerkship/elective/course director or his/her designee.
Non-AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the clerkship director to best align with the site schedule. Students may request to schedule 1 or more of these 4 days for planned absences that fall under 1 of the categories listed below for excused absences during non-AI rotations, in consultation with the course/elective director, who may or may not approve such planned absences.
AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the course director to best align with the site schedule. Students may request to schedule 1 or 2 of these days for planned absences that fall under 1 of the categories listed below for excused absences during AI rotations, in consultation with the course director, who may or may not approve such planned absences. Students must avoid scheduling Step 2 examinations during an Acting Internship.
Excused Absences - The following will be considered excused absences:
- Diagnostic, preventative, and therapeutic health services (e.g. doctor appointments, physical therapy, counselling, etc).
- Personal illness, accident or a major catastrophic event
- Death or serious illness of immediate family members. Immediate family members, as defined by UC, are Grandparents, Brother, Sister, Brother-in law, Sister-in-law, Daughter-in-law, Son-in-law, Father, Mother, Mother-in-law, Father-in-law, Step-sister, Step-brother, Step-mother, Step-father, Spouse or domestic partner, Child, Grandchild, legal Guardian or other person who stands in place of parent (in Loco Parentis)
Whenever possible, planned absences should be requested a minimum of six weeks in advance of the start of the clerkship/elective/course in which the absence will occur; this enables the clerkship/course/elective to help plan for educational event scheduling (e.g. a known appointment could be scheduled around with enough notice and the student might not have any required coursework to make up). Absences requested less than 1 week prior to the planned absence may not be considered for a possible excused absence unless extenuating circumstances prevented the student from providing timely notification per the policy. Students should first submit their request for a planned absence to the clerkship/elective/course director using the online MSSF. All planned/excused absences for any reason should be documented on the MSSF.
The COM abides by the UC Religious Observance Policy that respects the religious diversity of its students by providing opportunities, where possible, for accommodation in cases where conflicts exist between students’ religious beliefs/practices and educational activities. In clinical settings, such accommodations must honor the primacy of a commitment to patient care and avoid unduly burdening faculty, staff and the general student population involved in the affected educational and/or patient care activity.
The following items are explained in detail in the Medical Student Handbook:
- Excused/unexcused/unplanned absence, religious holidays, jury duty, and make-up work

See Attendance and Absences Policy, Religious Observance Policy, Medical Student Handbook.