Introduction to Pediatric Critical Care Medicine

Director(s): Debra Hillier, Alan Leichtner
Prerequisites: HMS Principal Clinical Experience (Core Clinical Clerkships) or equivalent
Offered: Full time every month. Closed in April.
Location: CHMC - Children's Hosp Medical Center (7)
Open to Exclerks: US/Canadian
Description: Introduction to Pediatric Critical Care is a course offered to 4th year and qualified 3rd year medical students interested in the evaluation, stabilization, and management of critically ill children. The course encompasses 4 weeks, during which time the student rotates through both units of the Medicine Critical Care Program. During their time in rotation, the student should maintain a case load of 1-2 patients. The medical student participant will round with the Unit team and present their primary patient. It is expected that he/she is the primary provider and advocate for his/her patient(s), and will be involved with all subspecialty services, allied professionals, and family discussions. He/she shall be an integral part of management, and should develop strong working relationships with both the staff and patient families. The medical student shall be assigned to a Primary Resident who can co-sign orders and supervise clinical decision-making, with final supervision by the unit attending. Additionally, the student will be assigned to one co-director of the course who will provide individual support, feedback, and mentoring. The goal of the rotation is to provide opportunities for the student clerk to integrate and apply knowledge of basic sciences, pathophysiology, physical exam skills, and assessment/management of critically ill children, from the onset of acute illness to recovery. The student should not only gain understanding of their patients� disease processes, but additionally, criteria for the patient being defined as critically ill. Teaching will be given through a mix of didactic lectures and demonstrations (such as use of airway cart/mannequins), bedside instruction, and journal review. Schedule: � 4 weeks � 1st two weeks in Intermediate Care Program, 2nd two weeks in MICU � Exception to this structure will be made when the student is following a patient who transfers between units � Typical day: 7:30am � 5pm, no required call
Incorporation of Basic Science Content and Evidence-Based Medicine:
Basic science content is strongly emphasized through hands-on critical care patient management, such as the principles involved in ventilation status, hemodynamic compromise or stability, and pharmacokinetics of the drugs being used (pressors, bronchodilators, etc.) Evidence-based medicine is instructed not only via practice guidelines used for clinical decision-making, but also by doing journal reviews (there is a journal club), discussion of articles, and by doing a final presentation of a case with a literature search to support that presentation.
Grade Criteria:
Honors with Distinction: The honors with distinction student will excel in all areas of assessment. The student should seamlessly function within the team, building caring and therapeutic relationships with families and collegial relationships with team members. The honors with distinction student will take on independent reading, and perhaps present summaries of relevant articles they have studied. Their daily patient presentations will be precise, show logical flow, and have well-thought out assessments and plans for patients. Case presentation will be evidence-based, up to date, and informative. Essentially, the honors with distinction student will perform at the level of an intern or junior resident. Honors: The honors student will demonstrate that they have gained a strong fund of knowledge during the rotation. The honors student should be an integral part of the wards team, and will demonstrate strong relationships and professionalism within the floor unit and team. The honors student should demonstrate that they have taken on independent learning, and their daily presentations should reflect their fund of knowledge not only of the patient but of the disease. Case presentation should be thorough and informative. Satisfactory: The satisfactory student performs the tasks asked of them and performs well within the wards team, although may not feel like as integral a member as an honors or honors with distinction student. The satisfactory student learns from the rotation but may not demonstrate independent learning or processing of evidence-based based medicine. Daily patient presentations will be adequate, even if not necessarily concise and targeted. End of rotation case presentation should meet required criteria. Unsatisfactory: The unsatisfactory student would be deficient in multiple areas of assessment. The student would demonstrate unreliable work ethic, poor relationships with colleagues, and/or minimal learning during the rotation. In particular, the unsatisfactory student would not incorporate feedback given by supervisory physicians (residents, attendings) into their practice, and as a result, would not show improvement during the course.