PGY-1 Pediatric ER - University of Chicago (elective)

PGY-1 Residents spend one month electively in the Emergency Department at Comer Children’s Hospital

COMPETENCY 1. Patient Care – Residents are expected to provide patient care that is compassionate, appropriate and effective for the promotion of health, prevention of illness, and the treatment of disease. To that end, the resident will:

  • Gather accurate, essential information from all sources, including medical interviews, physical examinations, medical records, diagnostic/therapeutic procedures, and subspecialist consultation when appropriate.
  • With the assistance of the attending physician, 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
  • Discuss all evaluations and plans with the ED attending prior to the patient’s discharge

COMPETENCY 2. 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 and the education of others, and apply an open-minded, analytical approach to acquiring new knowledge. The resident will access and critically evaluate current medical information and scientific evidence, and apply this knowledge to clinical problem-solving, clinical decision-making, and critical thinking.

-> Through clinical experience, attending physician education, and independent reading, resident knowledge should include, but not be limited to, the following disorders, and should emphasize the pathophysiologic correlates of the clinical situations:

  • acute major and minor medical problems, including but not limited to respiratory infection, respiratory failure, cardiopulmonary arrest, dehydration, coma, seizures, diabetic ketoacidosis, asthma, skin disorders, pyelonephritis, sepsis, shock, fever, and childhood exanthems
  • acute manifestations or exacerbations of chronic diseases
  • acute major and minor surgical problems, including but not limited to appendicitis, bowel obstruction, burns, foreign body inhalation and ingestion, abscess drainage, and head trauma;
  • poisonings and ingestion
  • physical and sexual abuse
  • minor trauma (including splinting, casting, and suturing)
  • acute psychiatric, behavioral, and psychosocial problems
  • admission or discharge planning, including communication with the personal physician

-> The resident is expected to review clinical guidelines for the above disorders found on the Chief Resident website as well as review other pertinent literature related to the above conditions

COMPETENCY 3. 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

  • Follow up and record the outcomes of laboratory results and hospital course on all patients to whom they provide care, to learn whether the initial impressions and plans were correct
  • Analyze practice experiences to continually improve the quality of patient practice
  • Develop and maintain a willingness to learn from errors and use errors to improve the system or processes of care
  • Use information technology or other available methodologies to access and manageinformation, support patient care decisions and enhance both patient and physician education

COMPETENCY 4. Interpersonal and Communication Skills – Residents are expected to demonstrate interpersonal and communication skills that enable them to establish and maintainprofessional relationships with patients, families, and other members of health care teams, and

  • Demonstrate respect for the privacy of the patient/family – knock before entering a room, and close the door and curtain prior to evaluating the patient
  • Create an effective clinical environment by turning on the lights and turning off the television
  • Consistently introduce themselves and their role in the patient’s care
  • Sit down and give  undivided attention to the patient and their family
  • Explain to the patient/family the thoughts/plans for their illness, work-up, and management in term they can understand
  • Always explain that the resident will be discussing plans with the supervising doctor whowill be in shortly to re-examine the patient
  • Demonstrate the willingness to discuss risk/benefit/cost options with the patient/family/attending
  • Consistently give written instructions that reinforce verbal instructions

COMPETENCY 5. 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
  • Recognize and identify deficiencies in peer performance and give constructive feedback
  • Refrain from judging families who have chosen the ED as a care location in lieu of a clinic option, but instead re-educate them on the importance of a medical home

COMPETENCY 6. Systems-Based Practice – Residents are expected to demonstrate both an understanding of the contexts and systems in which health care is provided, and the ability to apply this knowledge to improve and optimize health care. The resident should:

  • Discuss the limitations and opportunities inherent in various insurance coverage 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
  • Describe the necessary components of a comprehensive pediatric emergency room
  • Remain sensitive to the need to provide expeditious care to minimize the number of patients who leave without being seen