Ambulatory Pediatrics +/- Bioethics Concentration

• Elective Site Directors:

  • Dr. Gene LaBarge

    • gene.labarge@health.slu.edu

    • Cell (text or call) at 314-698-3247

  • Dr. Joshua Arthur

    • josh.arthur@health.slu.edu

• Up to 3 fourth year students can enroll in Ambulatory Pediatrics at a time. During a block bioethics is offered, up to 1 of the students can choose that track.

• Professionalism

  • Consistently professional interactions with faculty, staff, patients, residents, and colleagues

  • You are required to attend all assigned clinics and arrive on time

• Clinical Performance

  • You are expected to see patients independently, present verbally to your preceptor, and complete the patient visit with your preceptor. (Note: in certain subspecialty clinics, you may be limited to active observation)

  • Documentation is expected to be thorough and completed by the end of each day

• Academic Responsibilities (see IM-451 Canvas site for further description of assignments)

  • Complete written assignment (Pediatrics in Review) thoroughly and on time.

    • Of the articles provided, read any three of your choice

    • For each topic, summarize 3 preventive health or diagnostic principles, 3 management principles, and one specific patient application of these principles

  • EBM: read articles and complete appropriate worksheets prior to group session and engage fully in the discussion of the article

    • Goal: Critically appraise assigned articles using the JAMA Users’ Guide to the Medical Literature.

    • Use the appropriate JAMA Critical Appraisal worksheet to appraise each assigned article

    • Participate in group discussion of the articles

  • Communications / Ethics session: attend group session and engage fully (optional for ethics track students)

  • Complete all assigned feedback and assessment forms with your faculty preceptor

Well child care and anticipatory guidance

• Infants

• Children

• Adolescents and young adults

• Immunizations

• Development and developmental screening

• Advocacy

Problem based visits

• ADHD

• Asthma/RAD

• Atopic Dermatitis

• Bronchiolitis

• Cellulitis

• Constipation

• Gastroenteritis

• Malnutrition/poor weight gain in an infant or child

• Otitis

• Pharyngitis

• Urinary tract infections

Well Baby Nursery

• ABO incompatibility

• Breastfeeding problems

• Delayed stooling

• Delayed urination

• Dysmorphic features

• Heart murmur

• Hypoglycemia

• Hypocalcemia

• Infant of a diabetic mother

• Infant of a GBS positive mother

• Irritability in an infant

• Large for gestational age

• Neonatal abstinence syndrome

• Neonatal fever

• Normal late premature newborn

• Normal term newborn

• Physiologic jaundice

• Post-mature newborn

• Respiratory distress

• Small for gestational age

• Trisomy 21

Ethics Committee

• 4th Tuesday of the Month 7:30-9AM

• Hussman Room, 1st floor CG

• All proceedings confidential

SLU Center for Healthcare Ethics - Clinical Ethics Case Discussion

• 1st Thursday of the month, 12:30-1:45

• Salus Center, Albert Gnaegi Center for Healthcare Ethics, 5th floor, CHCE

• A confidential case usually from CG. Lunch provided.

Ethics Brown Bag Lunch case discussions

• 4th Monday of the month, 12-1

• Hussman Room, 1st floor CG

• Usually discussing topics/cases from CG. No lunch provided.

NICU Complex and Chronic Care Conference (C-Quad)

• Every other Wed, 12-1

• Mantych Room

*All proceedings confidential

*Bioethics concentration students strongly encouraged to participate. Optional for others

• Use the Pediatric student coaching form when working with Dr. Maatouk, Dr. Nicastro and other attendings outside of the General Ambulatory Pediatric group

  • Share the link: e-mail or QR code scan on your badge. The form can be completed on any computer or smart phone.

  • Assessment and comments available to our office immediately. We share these with Dr. Labarge and Dr. Arthur who uses the comments in formulating the final evaluation in OASIS.

• Student performance evaluations are assigned to Dr. LaBarge or Dr. Arthur (bioethics concentration) who complete them based on his own experience as well as feedback from the team. They are able to review your rotation activities and physicians you worked with using the Learners on Pediatrics spreadsheet.

• Final grade assessment will be consistent with IM-451 guidelines.

• Reflect on your elective/site goals, progress you made, and next steps

• Complete OASIS evaluations. Evaluations of elective or clinical site, as well as the course director are automatically assigned. You are encouraged to evaluate supervising physicians and need to add those evaluations in OASIS.

• "Pay it forward challenge"

  • Update clinical site information (mirror documents of information posted on the website) with anything you know now and wish you had known when starting: corrections, tips, and/or individual study resources. You should be able to edit and comment directly. We review these regularly and use this information to update the website.

• Touch base with any incoming students

• Try to enjoy each clinic experience, even if it sometimes ends up being more “shadowing”. There is still a lot to learn from various physicians about what questions to ask and how to get the patients to communicate

• Actively observe other professions involved with the clinic such as nurses, PT/OT, dieticians, etc: you will learn more aspects of patient care and how the team all works together

  • If you are interested in learning how to administer vaccinations, ask the nurses if you can first watch and then do one!

• Don’t forget the HEADSS assessment in teens!

• Make sure to review developmental milestones children should be reaching, these will be asked in every well child visit.

• Be sure to include what vaccinations your patient may need at this visit based on their age in your plan when presenting.

• Bioethics concentration

  • Throughout, think about what you will want to reflect on for your ethical case reflection

  • Try to complete at least one assignment a week, or they will pile up at the end

  • Look at every day with a lens of ethics: why do people make certain decisions? Is there only one right decision? How do doctors navigate helping families make the “best” decision to minimize harm and suffering? How do we define harm or suffering or best interest?