Rotation Title: MMC Newborn and Inpatient Pediatrics
Faculty Chair: Clark Alves, MD
Additional Contacts: Dolores Gomez, MD, Fernando Indacochea, MD, Gretchen Struemph, MD
ACGME Program Requirements (see IV.C.) This experience must include a minimum of 75 inpatient encounters with children.
Goal: The overall goal of the MMC Newborn and Inpatient Pediatrics rotation is to provide residents with the necessary foundation for diagnosis and management of common conditions requiring admission to the hospital among newborns, children and adolescents. This foundation should include the ability to distinguish normal from abnormal findings in newborns and other Pediatric patients.
Expectations for Residents and Faculty (if beyond those outlined in resident manual): None.
Deliverables (if applicable): Residents will read the assigned articles and list 3 items they learned from each of these articles in a Word document and submit this document to the faculty chair at the end of the rotation (there are 14 articles, residents are encouraged to ready 1 article per day during a 2-week rotation or 1 article every other day during a 4-week rotation). Residents will log at least 3 neonatal circumcisions, 1 sublingual frenotomy and 1 neonatal resuscitation in New Innovations by the end of the rotation (residents should attend every delivery that is also attended by NICU nurses and participate actively in the resuscitation process if needed). The resident will also round with the lactation consultant at least one day during the rotation to learn about techniques to optimize breastfeeding success.
Competency-Based Education
ACGME Program Requirements (see IV.B.)
| Objective (competencies) | Educational Strategies | Assessments |
| By the end of the rotation, the resident will demonstrate adequate understanding of common conditions encountered during the inpatient care of newborns and other Pediatric patients (MK) | Reading AAFP articles listed below and submitting three learning points from each article to the faculty chair. Clinical teaching by faculty. | Review of faculty evaluation of medical knowledge. |
| By the end of the rotation, the resident will demonstrate competency in performing neonatal circumcisions, sublingual frenotomy and neonatal resuscitation (PC) | Performance of at least 3 neonatal circumcisions (either Gomco or Plastibell technique), 1 sublingual frenotomy and 1 neonatal resuscitation under supervision of faculty (be sure to watch videos listed below before start of the rotation) | Review of procedure logs in New Innovations. Review of faculty evaluation of patient care. |
| By the end of the rotation, the resident will develop the ability to navigate the psychosocial dynamic between children and their caregivers (PRO, ICS) | Direct observation of resident interactions with patients and their caregivers (including nursing staff) by faculty with immediate feedback and coaching. | Review of faculty evaluation of professionalism and interpersonal skills and communication. |
| By the end of the rotation, the resident will demonstrate competency in maternal counseling regarding techniques to optimize breastfeeding success (MK, PRO, ICS) | Rounding with lactation consultant on at least one day of the rotation. Reading article on breastfeeding techniques. | Review of faculty evaluation of medical knowledge, professionalism and interpersonal skills and communication. |
| By the end of the rotation, the resident will develop the ability to utilize available resources in the hospital and community to address health disparities in Pediatric outcomes, including evidence-based use of inpatient services, diagnostic tests and therapies (PRO, SBP). | Direct observation by faculty of residents as they call upon social work/case management, Aprendamos, WIC and CYFD to facilitate appropriate care for their Pediatric patients, with immediate feedback and coaching. | Review of faculty evaluation of professionalism and systems-based practice. |
| By the end of the rotation, the resident will demonstrate a commitment to personal growth in the competencies listed above, with increasing responsibility and decreasing supervision by senior residents and faculty as the rotation progresses (PBLI). | Clinical teaching and feedback from the community preceptor. | Review of faculty evaluation of practice-based learning and improvement. |
Resources:
Gomco Circumcision Video: https://med.stanford.edu/newborns/professional-education/circumcision/gomco-clamp-technique.html
Plastibell Circumcision Video: https://med.stanford.edu/newborns/professional-education/circumcision/plastibell-technique.html
Growth Faltering and Failure to Thrive in Children, AAFP, 2023; https://www.aafp.org/pubs/afp/issues/2023/0600/growth-faltering-failure-to-thrive.html
Neonatal Hyperbilirubinemia: Evaluation and Treatment, AAFP, 2023; https://www.aafp.org/pubs/afp/issues/2023/0500/neonatal-hyperbilirubinemia.html
Neonatal Hypoglycemia, Seminars in Fetal and Neonatal Medicine, 2017; https://downloads.aap.org/AAP/PDF/Seminars_in_Fetal_Neonatal_Medicine.pdf
Newborn Respiratory Distress, AAFP, 2015; https://www.aafp.org/pubs/afp/issues/2015/1201/p994.html
Neonatal Early Onset Sepsis Calculator, AAFP, 2021; https://www.aafp.org/pubs/afp/issues/2021/1200/p636.html
Brief Resolved Unexplained Events in Low-Risk Infants, AAFP, 2017; https://www.aafp.org/pubs/afp/issues/2017/0301/p330.html
Croup: Diagnosis and Management, AAFP, 2018; https://www.aafp.org/pubs/afp/issues/2018/0501/p575.html
RSV Bronchiolitis: Rapid Evidence Review, AAFP, 2023; https://www.aafp.org/pubs/afp/issues/2023/0700/respiratory-syncytial-virus-bronchiolitis.html
Community Acquired Pneumonia in Children: Rapid Evidence Review, AAFP, 2021; https://www.aafp.org/pubs/afp/issues/2021/1200/p618.html
Acute Asthma and Other Recurrent Wheezing Disorders in Children, AAFP; 2013; https://www.aafp.org/pubs/afp/issues/2013/0715/p130.html
Gastroenteritis in Children, AAFP, 2019; https://www.aafp.org/pubs/afp/issues/2019/0201/p159.html
Peritonsillar Abscess, AAFP, 2017; https://www.aafp.org/pubs/afp/issues/2017/0415/p501.html
Diagnosing Appendicitis in Children and Adolescents, AAFP, 2023; file:///C:/Users/RID4428/Downloads/p301.pdf
Breastfeeding: Common Questions and Answers, AAFP, 2018; https://www.aafp.org/pubs/afp/issues/2018/0915/p368.html
SNMFMRP Curriculum 