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PGY6 YEAR
Block 1: July - October 2012
Competency - Interpersonal and Communication Skills
Goal - Develop interpersonal and communication skills that result in the effective exchange of information and collaboration with health professionals
Objectives
1. Prepare and deliver a lecture to emergency department faculty, fellows, residents, and medical students on new fads at that potential can be very dangerous to the pediatric population
2. Prepare and deliver a lecture to ED residents
Assessment Tool
1.Verbal feedback from faculty, fellows and residents after my lectures
2. Written feedback from faculty and fellows present at my lectures

Competency - Patient Care
Goal - Develop patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health
Objective
1. Assess my patient care for 4 patients using the patient/family feedback forms and process
Assessment Tool
1. Verbal feedback from families


Block 2: November 2012 - February 2013

Competency - Professionalism
Goal - Develop a commitment to carrying out professional responsibilities and an adherence to ethical principles
Objective
1. Evaluate my professionalism and communication skills with the nursing staff during pediatric emergency department shifts
Assessment Tool
1. Written evaluations from nursing staff in the pediatric emergency department

Competency - Practice-based Learning and Improvement
Goal - Develop the ability to investigate and evaluate my care of patients
Objectives
1. Develope and improve on my medical charting with the new Epic systems in the pediatric emergency department
Assessment Tool
1. Verbal assessment and feedback of charting and efficiency by fellow colleagues



Block 3: March - June 2013
Competency - Systems-Based Practice
Goal - Develop an awareness of and responsiveness to the larger context and system of health care
Objectives
1. Add to current medical knowledge whether the 5 finger test for weight is as good as the barslow
Assessment Tool
1. Approval of my completed scholarly project by my Scholarship Oversight Committee
2. Submission of my completed scholarly project to a peer-reviewed medical journal

Competency - Systems-Based Practice
Goal - Develop the ability to call effectively on other resources in the system to provide optimal health care
Objective
1. List indication for transfer referral for burns in the pediatric emergency department
2. Review the literature on burns in the pediatric emergency department
3. Present my list and review to the fellows and faculty at the next Thursday seminar
Assessment Tool
1. Verbal feedback from the fellows and faculty at the next Thursday seminar


PGY5 YEAR
July 2011 Elective Ultrasound
Competency - Medical Knowledge
Goal - Learn how to utilized the ultrasound machine, be able to recognized typical signs on the ultrasound
Objectives
1. Review chapters within the pocket ultrasound textbook on technique and methods
2. Attend Tuesdays teaching series with rad tech
3. Review ultrasounds that I have performed with Karen (Ultrasound) and Dr.Tae Kim

Assessment Tool
1. Verbal feedback on ultrasound technique and ability to read ultrasounds by Karen (Ultrasound) and Dr.Tae Kim

August 2011 Adult ED/ EMS
Competency - Interpersonal and Communication Skills
Goal - Develop interpersonal and communication skills that result in the effective exchange of information and collaboration with health professionals
Objectives
1. Demonstrate communication skills by participating in radio room paramedic calls
2. Discuss 5 calls with the adult emergency department attending on duty at the time of the calls
3. Discuss 5 calls with the MICN on duty at the time of the calls
Assessment Tool
1. Verbal feedback from the attending physician and MICN supervising me during the radio room calls

September 2011 Pediatric Emergency Department
Competency - Patient Care
Goal - Develop patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health
Objective
1. Provide care to a diverse population in the pediatric emergency department
2. Demonstrate effective communication with a diverse population of patients in the pediatric emergency department
Assessment Tool
1. Written feedback from families in the pediatric emergency department

October 2011 Elective
Competency - Medical Knowledge
Goal - Develop knowledge of established and evolving biomedical, clinical, and epidemiological and social-behavioral sciences, as well as the application of this knowledge to patient care
Objective
1. Read Park "How to Read Pediatric EKGs.
2. Attend Pediatric electrophysiology clinic at the LLUMC Heart Institute
3. Go over EKGs from the month with Barry NP and Dr. Mannapati
4. Review ingestions commonly seen in the pediatric ED
Assessment Tool
1. Verbal feedback from attending physicians
2. Self reflective essay on this month of toxicology, and pediatric EKG
3. Review test toxicology test questions with Dr. Rhee

November 2011 Pediatric Emergency Department
Competency - Professionalism
Goal - Develop a commitment to carrying out professional responsibilities and an adherence to ethical principles
Objective
1. Evaluate my professionalism and communication skills with the nursing staff during pediatric emergency department shifts
Assessment Tool
1. Written feedback from nursing staff in the pediatric emergency department

December 2011 Pediatric Emergency Department
Competency - Medical Knowledge
Goal - Develop knowledge of established and evolving biomedical, clinical, and epidemiological and social-behavioral sciences, as well as the application of this knowledge to patient care
Objective
1. Read and review the California state syllabus on fluoroscopy and radiation protection
Assessment Tool
1. Successful testing and application completion for the California fluoroscopy supervisor and operator permit within the next 2 months
2. Obtain hospital privileges at Loma Linda University Medical Center and Children's Hospital for fluoroscopy

January 2012 Pediatric Emergency Department
Competency - Patient Care
Goal - Develop knowledge of established and evolving biomedical, clinical, epidemiological and social-behavioral sciences, as well as the application of the knowledge to patient care
Objectives
1.Correlate the physical exam and radiographic findings suspicious for non-accidental trauma in pediatric patients
2. Review the major injuries suspicious for non-accidental trauma
3. Review the mechanisms of injury for injuries suspicious for non-accidental trauma
Assessment Tool
1. Verbal feedback with faculty and fellows at the next Thursday seminar.

February 2012 Adult Emergency Department
Competency - Interpersonal and Communication Skills
Goal - Develop interpersonal and communication skills that result in the effective exchange of information and collaboration with health professionals
Objective
1. List terms used to describe extremity injuries in children seen in the pediatric emergency department
2. As you see injuries in the ED be able to name the eponymous, extremity, spine, and pelvis injuries and discuss the case with the attending at that time
Assessment Tool
1. Continue to list out the eponymous and discuss them with an attending pediatric emergency physicians and during Thursday seminar

March 2012 Elective
Competency - Practice-Based Learning and Improvement
Goal - Develop the ability to continuously improve patient care based on constant self-evaluation and life-long learning
Objective
1. Review the published medical literature regarding facial trauma in children
2. Lecture on this topic
Assessment Tool
1. Written feedback on my lecture by faculty and fellows

April 2012 Pediatric emergency department
Competency - Systems-Based Practice
Goal - Develop an awareness of and responsiveness to the larger context and system of health care
Objective
1. List the social services resources available in the pediatric emergency department
2. List the pediatric specialties and subspecialties available for consultation or referral in the pediatric emergency department
3. Discuss these lists with at least one attending pediatric emergency physician
4. Visit with the Communications Center to ensure that all patient's who I've intended to refer to a specific clinic have been able to get into that clinic within a timely manner.
Assessment Tool
1. Verbal feedback from faculty on the completeness of my lists

May 2012 Elective
Competency - Practice-Based Learning and Improvement
Goal - Develop the ability to continuously improve patient care based on constant self-evaluation and life-long learning
Objective
1. Review the published medical literature regarding Environmental injuries in children
2. Give a lecture/case review on this topic
Assessment Tool
1. Written feedback on my lecture by faculty and fellows


June 2012 Pediatric Emergency Department
Competency - Interpersonal and Communication Skills
Goal - Develop interpersonal and communication skills that result in the effective exchange of information and collaboration with health professionals
Objectives
1. List the components of a completed emergency department record
2. Demonstrate completed emergency department records of all levels done throughout the month to Dr. Tim Young
3. Discuss this list and my completed emergency department records with Dr. Young
Assessment Tool
1. Verbal feedback from Dr. Young

PGY4 YEAR
July 2010 Pediatric Emergency Department
Competency - Medical Knowledge
Goal - Develop knowledge of established and evolving biomedical, clinical, and epidemiological and social-behavioral sciences, as well as the application of this knowledge to patient care
Objectives
1. Review the on-line PubMed tutorial from the National Library of Medicine available here
2. Review the literature on the clinical presentation and disease associations of Raynaud's phenomenon in children and adolescents
3. Discuss this literature review on Raynaud's phenomenon with an attending pediatric emergency physician
Assessment Tool
1. Self-reflective essay on what I learned about Raynaud's phenomenon

August 2010 Pediatric Intensive Care Unit
Competency - Practice-Based Learning and Improvement
Goal - Develop the ability to appraise and assimilate scientific evidence
Objective
1. Review the literature on the management and treatment of respiratory emergencies in the pediatric emergency department and pediatric intensive care unit (this topic will be narrowed based on my PICU experience)
2. Discuss my literature review with an attending pediatric intensivist
3. Present this literature during my required PICU lecture
Assessment Tool
1. Verbal feedback of my presentation by PICU faculty and fellows

September 2010 Pediatric Emergency Department
Competency - Interpersonal and Communication Skills
Goal - Develop interpersonal and communication skills that result in the effective exchange of information and collaboration with patients and their families
Objectives
1. Provide care to a diverse population in the pediatric emergency department
2. Demonstrate effective communication with a diverse population of patients in the pediatric emergency department
Assessment Tool
1. Written feedback from families in the pediatric emergency department

October 2010 Elective
Competency - Medical Knowledge
Goal - Develop knowledge of established and evolving biomedical, clinical, and epidemiological and social-behavioral sciences, as well as the application of this knowledge to patient care
Objective
1. Review general pediatric topics relevant to the practice of pediatric emergency medicine
2. Test my knowledge of these general pediatric topics with written practice tests
Assessment Tool
1. Practice test results

November 2010 Adult Emergency Department
Competency - Patient Care
Goal - Develop patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health
Objective
1. Develop an individual learning plan related to the management of acute myocardial infarction in adults (topic to be narrowed or modified based on my experience in the adult emergency department)
Assessment Tool
1. Completion of the individual learning plan

December 2010 Pediatric Emergency Department
Competency - Professionalism
Goal - Develop a commitment to carrying out professional responsibilities and an adherence to ethical principles
Objective
1. Complete charts within a timely manner this month
2. Develop and complete my "make man whole" project
Assessment Tool
1. Notifications from Health Information Management or the Graduate Medical Education Office regarding completion of my charts
2. Plan my "make man whole" project

January 2011 Adult Emergency Department
Competency - Patient Care
Goal - Develop knowledge of established and evolving biomedical, clinical, epidemiological and social-behavioral sciences, as well as the application of the knowledge to patient care
Objective
1. Review the literature regarding the management of urgent and emergent hypertension in adults
2. Discuss this literature with attending general emergency physicians on duty
Assessment Tool
1. Verbal feedback from attending physician regarding management

February 2011 Pediatric Emergency Department
Competency - Interpersonal and Communication Skills
Goal - Develop interpersonal and communication skills that result in the effective exchange of information and collaboration with health professionals
Objective
1. List terms used to describe extremity injuries in children seen in the pediatric emergency department
2. As you see injuries in the ED be able to name the eponymous, extremity, spine, and pelvis injuries and discuss the case with the attending at that time
Assessment Tool
1. Verbal feedback from attending pediatric emergency physicians

March 2011 Pediatric Emergency Department
Competency - Systems-Based Practice
Goal - Develop an awareness of and responsiveness to the larger context and system of health care
Objective
1. List the components of a completed emergency department record
2. Discuss 5 of my completed emergency department records with attendings that I've worked on the same patients with
Assessment Tool
1. Verbal feedback on my completed emergency department records

April 2011 Obstetrics
Competency - Systems-Based Practice
Goal - Develop the ability to call effectively on other resources in the system to provide optimal health care
Objectives
1. Demonstrate competent skills in delivery of a newborn
2. Discuss emergent obstetric complications associated with deliveries with an attending obstetrics physician
Assessment Tool
1. Perform multiple deliveries with verbal feedback at that time from Attending OB


May 2011 Pediatric Emergency Department
Competency - Medical Knowledge
Goal - Develop knowledge of established and evolving biomedical, clinical, and epidemiological and social-behavioral sciences, as well as the application of this knowledge to patient care
Objective
1. Review my SITE performance
2. Develop individual learning plans based on weaknesses identified in my SITE performance
Assessment Tool
1. Completion of these individual learning plans


June 2011 Elective
Competency - Interpersonal and Communication Skills
Goal - Develop interpersonal and communication skills that result in the effective exchange of information and collaboration with health professionals
Objectives
1. Prepare and deliver a lecture to emergency department faculty, fellows, residents, and medical students on pediatric overuse injuries
Assessment Tool
1.Verbal feedback from faculty, fellows and residents after my lectures
Objective
1. Read Park "How to Read Pediatric EKGs.
2. Attend Pediatric electrophysiology clinic at the LLUMC Heart Institute
3. Go over EKGs from the month with Dr. Mannapati or Dr. Koon that were difficult to interpret