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Electives - Pediatrics


ACE - A. I. in Neonatology

Elective Number: (Oasis E62h) 2411

Rotation Supervisors: Dr. Brooke Vergales

Designated Signer: Linda Crawford, 3rd Floor Old Medical School Rm 3590, (434) 924-5428

Duration: 4 weeks

Available: All rotations

Report to: Neonatology Fellow & Senior Resident

Time to Report: 6:30 am

Place to Report: Newborn Intensive Care Unit

Typical day: 6:30 am - 5:00 pm

Attendance: A student may not take time off during this rotation.

Number of students per rotation:

Course Description: This is an externship experience in the Neonatal Intensive Care Unit (NICU). . The student will perform those activities normally performed by an intern on their NICU rotation. They will serve as the primary physician for several sick neonates, with direct supervision by the NICU pediatric resident, fellow and attending physician This includes but is not limited to admitting and discharging patients, examining patients daily, writing daily progress notes, presenting their patients on daily rounds along with interpreting laboratory and radiology studies, attending high risk deliveries, attending and participating in intake rounds, and keeping parents updated on a daily basis. Students will complete 5-6 nights of night float with a NICU resident, neonatal nurse practitioner, and NICU fellow. There are also weekend call and rounds. There will also be the expectation that the student prepare and formally present on a neonatal topic during their month in the NICU. The final evaluation of the student will be determined by the input from their supervising physicians.
Goals: The goals of this course are to:
• Introduce the students to the multitude of conditions that are cared for in the neonatal intensive care unit and how this care is different from that of the normal newborn infant.
• Demonstrate professionalism by having personal accountability to patients, colleagues, and staff.
• Demonstrate evidence based-practice by accessing appropriate resources to answer clinical questions
Learning Objectives:
Patient Care:
• Independently perform comprehensive neonatal physical exams
• Perform with supervision common neonatal procedures, including active participation in neonatal resuscitation.
• Synthesize information from the maternal history as well as the neonatal history to formulate a differential and primary diagnosis.
• Modify the primary diagnosis based upon interpretation of diagnostic tests.
• Summarize interval patient information and rationale for ongoing clinical management.
• Develop and prioritize an inclusive problem list for sick neonates.
• Identify relevant clinical information necessary for hand-offs
• Reassess patient continuously.
• Demonstrate family-centered approach to patient care by involving parents in decision making.
Medical Knowledge:
• Understand the physiologic changes associated with perinatal transition from the intra uterine to extra uterine environment
• Appreciate that many common problems of neonatology reflect an aberrant transition.
• Describe the epidemiology, pathophysiology, and clinical findings of common neonatal conditions that require NICU admission.
o Respiratory distress
o Hyperbilirubinemia
o Congenital Heart Disease
o Prematurity
o Bilious Emesis/Distended Abdomen
o Congenital defects
o Neonatal Neurological issues
o Chromosomal Abnormalities/Syndrome
o Necrotizing Enterocolitis
o Retinopathy of Prematurity
• Describe indications, contraindications, risks and benefits of the following procedures:
o Arterial puncture or peripheral arterial line
o Capillary blood draw
o Chest tube placement or thoracentesis
o CPAP utilization
o Endotracheal intubation
o Intravenous catheter placement or PICC placement
o Lumbar puncture
o Nasogastric tube insertion
o Umbilical arterial or venous catheter placement
o Urethral catheterization
o Venous blood draw
• Know and be able to calculate the nutritional requirements for neonatal patients
• Recognize variation in neonatal vital signs as compared to other patients of differing ages
• Perform neonatal resuscitation and participate in one mock code to display knowledge.
Interpersonal and Communication Skills:
• Communicate effectively with patients and families across a broad range of socioeconomic and cultural backgrounds.
• Share information with the patient and family in a way that facilitates their understanding.
• Communicate patient information accurately and efficiently to all health care team members.
• Deliver organized, appropriately focused, and accurate oral patient presentations.
• Write organized, appropriately focused, and accurate patient notes, including keeping the problem list accurate and up to date.
Practice Based Learning and Improvement
• Demonstrate self-directed learning in daily practice by:
o Identifying strengths, deficiencies, and limits in one’s own knowledge and clinical skills through self-evaluation.
o Develop a plan for improvement.
o Read on individual patient conditions and report knowledge to NICU team on rounds.