Transition to Discipline

Short title (medSIS): TTD - EPA HISTORY PHYSICAL

Description:

• This EPA focuses on clinical assessment, verifying the skills achieved in medical school, including performing a basic history and physical examination and presenting the case.

• This EPA does not include correct diagnosis, management, or communication of the plan with the patient/family.

Assessment plan:

• Direct observation of the history and physical by supervisor or senior resident

• Collect 4 observations of achievement.

  • At least 1 neonate or infant

  • At least 1 preschool or school age

  • At least 1 adolescent

  • At least 2 observations by supervisor

  • At least 2 observations of a complete encounter that includes history, physical, and presentation

  • At least 1 observation of a complete encounter by supervisor

Milestones:

• Elicit an accurate, relevant history (ME 2.2)

• Conduct the interview in a patient-centred manner (COM 2.1)

• Perform a physical exam that informs the diagnosis (ME 2.2)

• Identify other sources of information (e.g., family, medical record) that may assist in the patient’s care (COM 2.3)

• Synthesize patient information from the clinical assessment for the purpose of written or oral summary to a supervisor (ME 2.2)

• Exhibit appropriate professional behaviours (P 1.1)

Mapped to the following training experiences:

Those in colour denote direct mapping, those in typical font denote those that may be possible during this rotation

• Orientation bootcamp

• Clinical Teaching Unit (CTU)

• Community pediatrics or Pediatric Emergency Medicine

• Subspecialty pediatrics

Short title (medSIS): TTD - EPA DOCUMENTING ORDERS

Description:

• This EPA focuses on written documentation of orders for assessment and management of any patient, after discussing the case with supervisor or a senior resident.

• This includes taking into account patient characteristics to adapt the assessment plan and/or dosing, and using the appropriate order structure and local order entry system.

• This EPA includes ordering diagnostic tests as well as treatments, such as intravenous fluids, medications, and diet/nutrition.

• This EPA may be observed in simulation.

Assessment plan:

• Review of clinical documentation by supervisor or senior resident

• Collect 6 observations of achievement.

  • At least 1 neonate/infant

  • At least 1 child/adolescent

  • At least 1 medication/prescription order

  • At least 1 intravenous fluids order

  • At least 1 diet/nutrition order

  • At least 3 observations by supervisor

Milestones:

• Document patient care orders (COM 5.1)

• Adjust medication dosing for patient age, size and/or other relevant factors (ME 2.4)

• Organize information in appropriate sections (COM 5.1)

• Complete assigned responsibilities in a timely fashion (P 1.1)

Mapped to the following training experiences:

Those in colour denote direct mapping, those in typical font denote those that may be possible during this rotation

• Orientation bootcamp

• Clinical Teaching Unit (CTU)

• Community pediatrics or Pediatric Emergency Medicine

• Subspecialty pediatrics

Includes sessions on the following topics:

• Welcome by Program Directors, Program Admin team, Chief residents, Chief/Chair of Department of Pediatrics, Associate Chair, Education

• Orientation to hospital and university IT platforms: meditech, sovera, citrix, PatientLink, medSIS, etc

• Logistics: how to request time off, what to do when unwell, leaves etc,

• Benefits of the program including conference funding

• Intro to key representatives/supports in the program: EDI, wellness reps, resident support network, social events

• Academic and clinical expectations of residents: "What’s required" in MacPeds

• Introduction to CBME including growth mindset and competence committee

• Tips for staying organized during residency

• Role of Family Advisory Council and tips for interacting with parents/families in pediatric residency

• Intro to family centred rounds on CTU

• Handover including iPASS format

• Taking a pediatric history

• Newborn examination

• Presenting a history and physical exam

• Common pediatric problems

• Writing pediatric orders, including order sets and patient safety

• How to call a consultant

• Suggested resources

• Neontal Resuscitation Program (NRP)

• Pediatric Advanced Life Support Program (PALS)

• Introduction to simulation

• Trial EPAs in stations - pediatric history/physical exam, presenting cases, documenting orders (TTD EPA #1, 2)

The following EPAs are mapped to orientation bootcamp:

Those in colour denote direct mapping, those in typical font denote those that may be possible during this rotation

• TTD EPA #1 - Performing and presenting a basic history and physical examination (Trial EPAs in stations)

• TTD EPA #2 - Documenting orders for pediatric patients (Trial EPAs in stations)

• FOD EPA #3 - Providing well newborn care - Part A: Newborn examination (Trial EPAs in stations)

• FOD EPA #7 - Performing basic pediatric procedures (NRP & PALS)

• bag valve mask ventilation

• cardiopulmonary resuscitation

• intraosseus injection

• needle thoracostomy in neonate

The following EPAs are mapped to this rotation:

Those in bold denote direct mapping, those in typical font denote those that may be possible during this rotation

• TTD EPA #1 - Performing and presenting a basic history and physical examination

• TTD EPA #2 - Documenting orders for pediatric patients

The following EPAs are mapped to this rotation:

Those in colour denote direct mapping, those in typical font denote those that may be possible during this rotation

• TTD EPA #1 - Performing and presenting a basic history and physical examination

• TTD EPA #2 - Documenting orders for pediatric patients

The following EPAs are mapped to this rotation:

Those in colour denote direct mapping, those in typical font denote those that may be possible during this rotation

• TTD EPA #1 - Performing and presenting a basic history and physical examination

• TTD EPA #2 - Documenting orders for pediatric patients