*Please select PDF files from the sidebar for your rotation of choice - note the PL year and that these are currently in draft form and will be updated shortly.
Overall Educational Core Program Goals and Objectives
Competency 1: Patient Care - Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.
Goal: Residents must gather essential and accurate information about their patients
Objective: Residents will develop the ability to obtain a complete history including a history of present illness, review of systems, past medical history, social history paying particular attention to cultural and religious beliefs, as well as a family history, developmental history, and list of medications (including non-conventional remedies), allergies, and vaccines
Objective: Residents will develop the ability to access old medical records and obtain information pertaining to previous hospitalizations, clinic visits, laboratory work and studies
Goal: Residents must be able to communicate effectively
Objective: Residents will develop the ability to present a history and physical exam in a clear and concise manner
Objective: Residents will develop the ability to explain to patients and families the diagnosis, nature of the disease and the expected course
Objective: Residents will develop the ability to effectively communicate medical information in a written format
Goal: Residents must demonstrate caring and respectful behaviors when interacting with patients and their families
Objective: Residents will consistently demonstrate caring and respect to patients and families through attitude, demeanor, verbal and non-verbal communications. Residents will be observed interacting with patients and critiqued on this interaction
Goal: Residents must make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up to date scientific evidence and clinical judgment
Objective: Residents will become adept at searching the literature to gather information on the most up-to-date treatment and management of diseases
Objective: Residents will develop the skill to appropriately identity and consult subspecialty services and resources
Goal: Residents must develop and carry out patient management plans
Objective: Residents will develop the skill to implement plans for the outpatient management of common diseases
Objective: Residents will see patients for appropriate follow up visits after a diagnosis has been made and a management plan initiated to assess the success of those management plans
Goal: Residents must counsel and educate patients and their families
Objective: Residents will become proficient in explaining to patients and families the diagnosis, nature of the disease, and the expected course
Goal: Residents must use information technology to support patient care decisions and patient education
Objective: Residents will become proficient at using online resources to review the literature and provide the most up-to-date medical care
Objective: Residents will develop the skills needed to identify and use web-based resources to provide patient handouts and instructions
Goal: Residents must perform competently all medical and invasive procedures considered essential for the area of practice
Objective: Residents will develop the ability to perform and interpret results of specific procedures and follow-up on the results with appropriate interventions
Objective: Residents will keep an active log of all procedures in which they have gained competence
Goal: Residents must work with health care professionals, including those from other disciplines, to provide patient focused care
Objective: Residents will practice and be able to explain the meaning and importance of patient and family centered care
Objective: Residents work appropriately with multiple disciplines including social work, nutrition, early intervention, physical therapy, occupational therapy, care coordination, insurance companies, and nursing in order to provide comprehensive patient care to create for their patients, a medical home
Competency 2: Medical Knowledge - Residents must demonstrate knowledge about established and evolving biomedical, clinical, and cognate (e.g., epidemiological and social-behavioral) sciences and the application of this knowledge to patient care.
Goal: Residents must be able to demonstrate an investigatory and analytic thinking approach to clinical situations
Objective: Residents will generate a differential diagnosis and unique treatment plan for each patient encounter. This will be accomplished through the judicious use of ordering appropriate diagnostic laboratory tests and radiologic studies to narrow a differential and to evaluate a specific treatment
Objective: Residents will effectively communicate their investigatory and analytic thinking approach via written notes and via their discussion of patient problems at clinical conferences and via didactic teaching sessions, and will seek and incorporate feedback for the improvement of both written and verbal communication
Goal: Residents must know and apply the basic and clinically supportive sciences which are appropriate to their discipline
Objective: Residents will keep abreast of new scientific knowledge. This knowledge will be obtained via didactic sessions, Grand Rounds, critical review of scientific literature (e.g., journal clubs) and computer and web-based resources
Objective: Residents will use as guidance for learning improvement the objective assessment of their fund of knowledge provided by the annual in-service training examination. They will use their feedback from this examination to guide self-learning efforts
Objective: Residents will participate actively in patient conferences along with health care providers who specialize in the clinically supportive sciences. These conferences will include medical, ethical, psychosocial issues, and culturally sensitive topics
Competency 3: Practice-Based Learning and Improvement - Residents must be able to investigate and evaluate their patient care practices, appraise and assimilate scientific evidence, and improve their patient care practices.
Goal: Residents must be able to analyze, evaluate and improve their own practice performance, skill, and style
Objective: Residents will develop the ability to identify gaps in knowledge based upon experiences, introspective awareness, and feedback
Objective: Residents will regularly review both textbook and primary source literature to maintain up to date understanding of specific topics that have arisen in practice
Objective: Residents will actively seek feedback and advice on practice from peers, mentors, staff, and patients alike to gain greater objective insight into their strengths and weaknesses
Goal: Residents must be able to locate, assess, and assimilate evidence and relevant information relating to their patients problems
Objective: Residents will become able to obtain scientific literature, appraise quality, and assimilate data through the use of up-to-date resources to improve their practice and care of patients' health problems
Objective: Residents will maintain an awareness of medical information that directly impinge on their own population of patients, for example through directives and publications from their local department of health, or national physician's organizations
Goal: Residents must effectively use information technology to access and manage on-line medical information to support their education, expertise, and certification
Objective: Residents will gain basic skills in literature search methodologies using standard web-based medical literature search engines such as Ovid, MD Consult, Pubmed, etc.
Objective: Residents will become familiar with a variety of computer and hand-held computer-based resources for looking up medications, dosing, growth and development charts, and other topics of use to the general pediatrician
Objective: Residents will utilize the resident based web page to document procedures and changes in educational plans
Objective: Residents will become familiar with web-based technologies required for documenting and maintaining continuing medical education progress and detail for ongoing board certification and medical licensure
Goal: Residents must actively participate in lectures and discussions with peers and experts on the topics related to the care of patients in the specific field of expertise of each educational experience
Objective: Residents will take a proactive and interactive approach to enhancing their knowledge, by "thinking out loud" , asking for clarification and guidance, and actively seeking input on their practice and knowledge base from their mentors
Competency 4: Interpersonal and Communication Skills - Residents must be able to demonstrate interpersonal and communication skills that result in effective information exchange and teaming with patients, their patients' families, and professional associates.
Goal: Residents must create and sustain a therapeutic and ethically sound relationship with patients
Objective: Residents will approach patients/families with a friendly, interested, and respectful demeanor
Objective: Residents will scrupulously maintain patient confidentiality, and specifically reassure patients/families of the confidentiality of their personal and medical information
Objective: Residents will make every effort to safeguard patient/family dignity
Objective: Residents will know and be able to describe the proper boundaries of the physician/patient relationship, and avoid any breach of these boundaries
Goal: Residents must cultivate and use effective listening skills, including nonverbal facilitation and encouragement
Objective: Residents will seek the services of a qualified interpreter in all communications with patients/families in which language discordance is an issue
Objective: Residents will acquire and demonstrate skill in active listening, including allowing time for patient/family explanations, minimizing interrupting except for clarification or necessary redirection
Objective: Residents will acquire and demonstrate skill in nonverbal communicative cues to facilitate disclosure and demonstrate physician interest and attention, including such examples as maintaining eye contact to a mutually comfortable degree; use of attentive silence, acknowledging specific points with head nods, use of appropriate facial expressions, "mm-hmm," etc.; maintaining an open posture, leaning forward to convey interest; and avoiding facial expressions that convey disapproval or negative judgment
Goal: Residents must elicit and provide information using effective explanatory, questioning, and writing skills
Objective: Residents will make explanations in clear, common-parlance language and avoid use of medical jargon when talking to patients and their families
Objective: Residents will clarify that patient's/family's concerns and questions are understood and addressed
Objective: Residents will clearly identify differences in patient/family and medical perspectives, bringing such differences into open discussion, and explain the rationale for medical actions that differ from patient/family preferences and values
Objective: Residents will demonstrate skill, clarity, and effectiveness in questioning patients/families, including: use of broad, open-ended questions progressing to more directed questions and specific prompts; and clarifying patients'/families' unclear statements
Objective: Residents will negotiate priorities for problems to be addressed in the particular visit, once all issues have been identified
Objective: Residents will write clearly and legibly when hand-writing instructions or other information for patients/families
Objective: Residents will help to ensure that written or printed information for patients/families is language-congruent and literacy appropriate: aimed at fourth to fifth grade reading level, using short words and sentences, straightforward language, and comprehensible and culturally appropriate illustration
Objective: Residents will ensure that their written communications in patient charts will effectively permit subsequent caregivers to understand the nature of the patient interaction and the goals and plans for the encounter as well as future encounters when applicable
Goal: Residents must be able to work effectively with others as a member or leader of a health care team or other professional group
Objective: Residents will complete timely and thorough written documentation in patient records
Objective: Residents will communicate effectively with other members of the patient's care team
Objective: Residents will acquire and demonstrate skill in conducting efficient and instructive patient rounds and organizing and directing a variety of types of teaching conferences and discussions (e.g., case conferences, Morning Report)
Objective: Residents will act as teachers and educational mentors to medical students and interns, helping students and interns to define patient care plans; and providing learners and timely constructive evaluation and feedback
Objective: Residents will actively seek the advice and knowledge of senior physicians and other parties with knowledge relevant to the care of patients (both in general and in specific individual instances)
Objective: Residents will master the logistics and appropriate use of specialty consults and their follow-up, including such non-medical resources as Social Work, Child Life specialists, the hospital Ethics Committee, Family Help and legal referral services, Risk Management, etc.
Competency 5: Professionalism - Residents must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population.
Goal: Residents must demonstrate respect, compassion, and integrity in their professional behavior
Objective: Residents will ask patients/family members how they wish to be addressed; avoid addressing adults by first name unless specifically invited to do so; and avoid addressing adults by role-name (e.g., "mom")
Objective: Residents will openly support and assist patients/families in dealing with health challenges and their administrative complications
Objective: Residents will know and avoid breach of the boundaries of the physician/patient relationship, including but not limited to strict avoidance of sexual or romantic suggestiveness or involvement with patients/family members
Goal: Residents must demonstrate responsiveness to the needs of patients and society that supercedes self interest
Objective: Residents will place patient safety and care above all competing considerations at all times
Objective: Residents will make reasonable efforts to act as advocates for their patients
Objective: Residents will place patients safety as their first priority, without compromising their own safety or the safety of others that they are supervising
Goal: Residents must demonstrate accountability to patients, society, and the medical profession
Objective: Residents will recognize and support patient's rights to receive full information regarding the risks, benefits, and costs of appropriate treatment options, and to be advised of potential conflicts of interest on the part of their physicians
Objective: Residents will truthfully report medical errors of their own to their attendings or to Risk Management, and will follow hospital policies in the face of errors. Residents will encourage and facilitate reporting of medical error on the part of professional colleagues
Objective: Residents will seek professional help for personal impairments that may compromise patient care and will assist impaired colleagues to obtain professional help
Objective: Residents will refrain at all times from any form of scientific misconduct in clinical practice, research, professional presentations, and publication
Objective: Residents will reject funding or contractual relationships which create conflict of interest with patient safety and optimal patient care, and will provide full disclosure of self-interest in all public presentations and in publications, as appropriate
Goal: Residents must demonstrate a commitment to excellence and on-going professional development
Objective: Residents will participate regularly in professional development and Continuing Medical Education activities and in the research project requirement of the residency program
Goal: Residents must demonstrate a commitment to ethical principles pertaining to provision or withholding of clinical care, confidentiality of patient information, informed consent, and business practices
Objective: Residents shall not withhold needed medical care from patients/families wishing to receive it, irrespective of ability to pay for such care
Objective: Residents will demonstrate a supportive attitude toward the appropriate decisions of parents (or recognized family decision makers) to withhold or withdraw life-sustaining treatment from pediatric patients in terminal conditions
Objective: Residents will refrain from revealing confidential communications or patient information to anyone not involved in the patient's care without the express consent of the patient/family, except where provided for by law (e.g., suspicion of child abuse)
Objective: Residents will fully and clearly inform patients and families of the benefits and risks of all proposed diagnostic and therapeutic interventions
Objective: Residents will avoid any form of coercion of patient/family decision making
Objective: Residents will obtain IRB approval for all research involving human subjects, and will consult the IRB and/or the hospital Ethics Committee on all appropriate matters
Objective: Residents will refrain from accepting gifts or incentives of any significance from companies producing pharmaceuticals and other medical products and devices, and from their representatives
Goal: Residents must demonstrate sensitivity and responsiveness to patients' culture, age, gender, disabilities, religion, sexual preference, and other parameters of human diversity
Objective: Residents will elicit and accommodate differing religious and cultural needs and values in delivering medical care
Objective: Residents will be able to identify their own cultural values and preferences, and to demonstrate awareness of how these preferences influence their delivery of care
Competency 6: Systems-Based Practice - Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value. By the end of their training, residents are expected to have attained competence in the following goals.
Goal: Residents must understand how their patient care and other professional practices affect other health care professionals, the health care organization, and the larger society and how these elements of the system affect their own practice
Objective: Residents develop the skills needed to work within a multidisciplinary team to develop a care plan for their patients
Objective: Residents will become familiar with hospital and community based health care professionals and their roles in groups such as social work, mental health professionals, PT, OT, dieticians, Early Intervention, etc.
Objective: Residents will evaluate and be able to articulate how interacting with the above groups and health professionals affects their own practice
Objective: Residents will gain a familiarity with the myriad pressures on health care systems (such as insurance companies, state government, HMO's, hospitals, etc.), and be able to evaluate and explain how these different systems in health care can influence their patient care
Goal: Residents must know how different medical practice styles and delivery systems influence resource allocation and health care costs
Objective: Residents will develop the skills to provide patient care in different clinical settings, such as inpatient, outpatient, telephone management, clinic based, etc; and will be able to identify which is the optimal setting to provide cost-effective and quality patient care for a variety of patient problems
Objective: Residents will develop the skills required to deliver preventative medicine such as immunizations, prophylactic medication, diet and exercise and will work to incorporate the fundamental aspects of preventative medicine into their own practice
Objective: Residents will become familiar with the presence and influences of alternative and complementary therapies, and its use in their populations and patients
Objective: Residents will practice cost-effective health care and resource allocation that does not compromise quality of care
Goal: Residents must advocate for quality patient care and assist patients in dealing with system based complexities
Objective: Residents will acquire familiarity with a variety of insurances and how they affect patient referrals and prescriptions. They will demonstrate an appreciation for the legal rights of the uninsured and will work with the appropriate services to assist patients who are under- or un-insured
Objective: Residents will develop the ability to interact and advocate effectively with other physicians, ancillary caregivers, community agencies, schools, landlords, and insurance companies, etc., via spoken and written communications, when it affects the health of their patients
Objective: Residents will become familiar with the various community resources available for patients and will work with case managers and social workers to enable patients to access these resources
Objective: Residents will demonstrate the ability to develop medical homes for disadvantaged and/or medical complex patients and families. Residents will be expected to play an active role in the medical homes and will work closely with families in their clinics to navigate the system complexities
Goal: Residents must know how to partner with health care managers and health care providers to assess, coordinate, and improve health care and know how these activities affect system performance
Objective: Residents will maintain responsible communications by phone and letter with their patients' primary care physicians
Objective: Residents will appropriately refer patients to subspecialists and communicate effectively with the subspecialists
