Goals and Objectives

PEDIATRIC NEUROLOGY GOALS & OBJECTIVES

Pediatric Neurology
Overall Program Goals & Educational Objectives

To prepare the physician for the independent practice of clinical, pediatric neurology by providing training
based on supervised clinical work with increasing responsibility for outpatients and inpatients.
To provide a foundation of organized instruction in the basic neurosciences.
To provide an opportunity to develop and maintain an investigative career in the basic neurosciences and in
clinical pediatric neurology.
To develop the many personal attributes necessary for becoming an effective physician, including honesty,
compassion, reliability and effective communication skills.

Goals:

To provide a concentrated exposure to neurologic disorders commonly encountered in pediatrics, including nervous system disorders requiring surgical or psychiatric evaluation and management.
To increase the resident's skills at diagnosing infantile and pediatric seizure disorders and selecting appropriate anticonvulsant therapy.
To provide an opportunity for residents to pursue directed readings that focus on pathophysiology of pediatric neurologic disease processes.

Educational Objectives:

To develop a logical approach in the evaluation and decision-making for children with neurologic problems. Following the rotation, residents should be able to obtain a detailed history, as it pertains to the pediatric population, and conduct comprehensive general and neurological examinations. Patient data should be documented in an organized fashion.
To learn to distinguish abnormal from normal patterns of development in the examination of infants and children.
To learn the indications for and interpretations of cranial CT and MRI scans of pediatric neurologic disorders.
To learn to manage pediatric patients with neurological problems, especially those with intractable epilepsy, neurogenetic disorders, neuromuscular disorders and neurobehavioral disorders. This will include exposure to basic EEG interpretation (routine and long-term monitoring).
To learn to evaluate mental retardation developmental disabilities, headache movement disorders, and neurovascular disease.

Pediatric Neurology Resident Responsibilities:

Patient Care

Residents are expected to provide patient care that is compassionate, appropriate and effective for the promotion of health, prevention of illness, treatment of disease and at the end of life. To that end, residents will:
- Gather accurate, essential information from all sources, including medical interviews, physical examinations, medical records and diagnostic/therapeutic procedures.
- Make informed recommendations about preventative, diagnostic and therapeutic options and interventions that are based on clinical judgment, scientific evidence, and patient preference.
- Develop, negotiate and implement effective patient management plans and integration of patient care.
Medical Knowledge

Residents are expected to demonstrate knowledge of established and evolving biomedical, clinical and social sciences, and the application of their knowledge to patient care. Residents will apply an openminded, analytical approach to acquiring new knowledge, access and critically evaluate current medical information and scientific evidence and apply this knowledge to clinical problem-solving, clinical decisionmaking and critical thinking.
Practice-Based Learning and Improvement Residents are expected to be able to use scientific evidence and methods to investigate, evaluate and improve patient care practices, and
- Identify areas for improvement and implement strategies to enhance knowledge, skills, attitudes and processes of care.
- Analyze and evaluate practice experiences and implement strategies to continually improve the quality of patient practice.
- Develop and maintain a willingness to learn from errors and use errors to improve the system of processes of care.
- Use information technology or other methodologies to access and manage information, support patient care decisions and enhance both patient and physician education.

Interpersonal and Communication Skills Residents are expected to demonstrate interpersonal and communication skills that enable them to establish and maintain professional relationships with patients, families, and other members of health care teams, and
- Provide effective and professional consultation to other physician and health care professionals and sustain therapeutic and ethically sound professional relationships with patients, their families and colleagues.
- Use effective listening, nonverbal, questioning, and narrative skills to communicate with patients and families.
- Interact with referring physicians in a respectful, appropriate manner.
- Maintain comprehensive, timely, and legible medical records.
- Complete evaluations of the attending, staff and rotation.
- Learn to give guidance and instruction to families regarding the management of their children with neurological disease.

Professionalism
Residents are expected to demonstrate behaviors that reflect a commitment to continuous professional development, ethical practice, an understanding and sensitivity to diversity and a responsible attitude toward their patients, their profession and society, and
- Demonstrate respect, compassion, integrity and altruism in relationships with patients, families and colleagues.
- Demonstrate sensitivity and responsiveness to the gender, age, culture, religion, sexual preference, socioeconomic status, beliefs, behaviors and disabilities of patients and professional colleagues.
- Adhere to principles of confidentiality, scientific/academic integrity, and informed consent.

Systems-Based Practice
Residents are expected to demonstrate both an understanding of the contexts and systems in which health care provided, and the ability to apply this knowledge to improve and optimize health care, and
- Understand, access and utilize the resources, providers and systems necessary to provide optimal care.
- Understand the limitations and opportunities inherent in various practice types and delivery systems, and develop strategies to optimize care for the individual patient.
- Apply evidence-based, cost-conscious strategies to prevention, diagnosis and disease management.
- Collaborate with other members of the health care team to assist patients in dealing effectively with complex systems and to improve systematic processes of care.

Specific Topics
Residents should become familiar with the following topics during their time on the rotation through experience, didactic sessions or reading:

Examination of the newborn, child and adolescent
Intracranial hemorrhage
Brain tumors
Pediatric movement disorders
Coma and stupor
CNS infections
Febrile seizures
Seizure disorders
Pediatric epilepsy surgery
Degenerative neurologic diseases
Demyelinating disorders
Neuromuscular diseases
Neurocutaneous diseases (Tuberous sclerosis, Neurofibromatosis)
Headaches
School problems, learning disabilities and Attention Deficit disorders
Cerebral palsy and management of spasticity
Critically ill child

Residents have access to the Pediatric Library located on the 5 th floor of the Children's Hospital.
Online Learning centers include the:

Child Neurology Society homepage – http://www.childneurologysociety.org/
Gene Tests homepage – http://www.genetests.org/
Online Mendelian Inheritance of Man (OMIM) – (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=OMIM)
Neuromuscular Disease Center – http://www.neuro.wustl.edu/neuromuscular/
Residents are encouraged to participate in ongoing research projects in pediatric neurology.