Ambulatory

STUDENTS IN THE AMBULATORY SETTING

A. Goal: Introduction to Pediatrics in the Ambulatory Setting

B. Objectives

1. Skills

a) To be able to take an appropriate pediatric history, both complete and focused.
b) To be able to do an adequate physical exam on children age newborn to 12 years and
adolescents/young adults and to recognize the differing requirements of each
c) To learn good interviewing techniques.
d) To learn the critical aspects of good record keeping.

2. Content

a) To be able to differentiate "sick" from “well" children and thereby to recognize the weight of importance to be placed on signs and symptoms at different ages.
b) To know the normal stages of growth and development. Growth and development charts (height, weight) and neurological development Denver or modification) required on alt charts.
c) To recognize the child's place written the family unit (social role of preventive medicine).

1. Students will be oriented by the Student Coordinator or designee in the ambulatory areas.

2. Students will be directly supervised by the attending physicians in these areas. If an attending is not available, a senior resident may supervise the student. When a student has finished the evaluation of his patient, he will call in an attending (or resident) who will review and discuss problems, assessment and plans, and recheck physical findings. When the chart is complete including instruction sheet) and plans for diagnosis, treatment and follow up are implemented and understood
by the patient and/or family, the student will sign his write up, and his supervisor will countersign it.

3. Students in CHC will follow the CHC and team conferences except for conferences on Thursdays.

4. Charts: When the student is seeing a patient with an appointment, he/she must perform and record a complete data base for that area and complete physical examination (including description of all pertinent negative findings). When the student examines a patient whose data base forms are not complete, the student will complete those forms.

For information on an appropriate history and physical exam on a pediatric patient, consult the references listed under General Information for the Clerkship. Another excellent reference on reserve in the library is:

Algrananti, P: The Pediatric Patient: An Approach to History and Phvsical Examination Williams & Wilkins, 1992.