Preceptor: Claire Hennigan, MD, Kelley Groves, MD
Contact: Lakesha Baker, Lakesha.Baker@NYULangone.org
Telephone: 212-263-8111
Prerequisites: Pediatric Clerkship

Who should enroll in this elective?

Students who are considering pediatrics as a career, as well as those considering subspecialties such as pediatric anesthesia, pediatric surgery, pediatric ENT, neurosurgery, and other surgical disciplines

Students who are entering an allied field, such as emergency medicine

Clinical site

Pediatric Intensive Care Unit (PICU), Kimmel Pavilion, 9^th floor

Description

This is an introductory 2-week elective to provide students with an overview of the field of Pediatric Critical Care medicine. Students will gain a broad understanding of the core principles, foundational knowledge, and essential skills relevant to the specialty.

The pediatric intensive care unit (PICU) is dedicated to providing care to critically ill medical and surgical patients by leveraging the strength of a multidisciplinary care team. The goal of this elective is to introduce important concepts and skills to promote basic understanding of the pathophysiology of common critical illnesses and the approach to clinical decision making when caring for critically ill children.

Students will be exposed to a range of patients with critical illness, including those with respiratory failure, septic shock, neurological emergencies, organ failure and transplantation, as well as patients with medical complexity (e.g. patients with technology dependence such as tracheostomies, feeding tubes, and ventilator dependence). Students will participate in pediatric critical care teaching rounds, observe bedside procedures such as central venous access, point of care ultrasound, intubation and spend time with members of the multidisciplinary care team (child life, music therapy, nutrition).

Objectives of the Elective

The Pediatric Critical Care Elective is structured to familiarize medical students with the recognition, evaluation, and management of pediatric patients with critical organ system instability. Over the course of 2 weeks, students will improve their knowledge in the following:

1. Recognition and management of isolated and multi-organ system failure and assessment of its irreversibility
2. Integration of clinical assessment and laboratory data to form treatment plans for critically ill children
3. Invasive and non-invasive methods of monitoring and supporting cardiovascular, pulmonary, cerebral, and metabolic functions
4. Pre- and post-operative management of surgical patients
5. Communicating with patients and families experiencing the stress of their child’s severe illness. This includes observation of discussions regarding prognosis and goals of care.
6. Basic principles of point of care ultrasound and its uses and limitations
7. Gain insight into the interdisciplinary nature of this specialty and how our clinicians interact with other medical disciplines to provide comprehensive patient care
8. Explore the option of pediatrics, and pediatric critical care, as a career choice

Key Responsibilities of the student while on Elective

By enrolling in this elective, you have agreed to:

1. Participate in at least 35 contact hours of education each week
2. Provide communication of any excused absences to the Office of Student Affairs (excused absence form) and to the elective coordinator, in a timely fashion
3. Arrive in a timely fashion to all locations to which you are assigned
4. Participate in daily morning rounds and patient care with residents and attendings
5. Be an active participant in the care of patients being followed by the team, as dictated by the resident/attending
6. Attend all didactics provided for trainees, as outlined below

You will be responsible for direct patient care, presenting their patients on rounds, completing documentation, and performing related clinical tasks as detailed below. You are expected to follow 2 to 3 patients throughout the elective. You are an integral part of the team under the direct supervision of residents, fellows, and attending physicians. You will be expected to:

1. Obtain and document a thorough history and physical on all assigned patients. Complete daily progress notes for those patients being followed longitudinally
2. Give clear, organized presentations of patients during rounds
3. Develop a plan of care in conjunction with the residents and critical care attending.
4. Follow-up on all labs and tests ordered
5. Re-evaluate patients and report changes to the resident, fellow, and attending as they occur
6. Expand knowledge of critical care medicine and basic physiology through teaching rounds and reading of suggested materials
7. Prepare a 15-20min case presentation and lecture based on a patient in the PICU you have cared for
   1. This presentation is not intended to be a formal power point presentation, can be done as a “chalk talk” style lecture
   2. Talk will be scheduled for the second week of the elective; you will arrange with attending on service base day/time for presentation

Key Responsibilities of the preceptor/faculty/residents while you are on Elective

By accepting your enrollment in this introductory elective, the preceptor agreed to:

1. Clearly communicate their expectations of you
2. Maintain a supportive clinical learning environment
3. Ensure you have access to a broad case mix and clinical experience
4. Provide the education necessary for you to gain an understanding of the patients and pathology reflective of this specialty
5. Provide feedback on your clinical skills

Didactic Program

Students will attend the following while on the rotation:

• Pediatric ICU Case Conference (required – weekly on Wednesdays 1PM)
• Pediatric Critical Care Fellowship Didactic Lectures and Simulations (required – weekly on Wednesdays 2-4 pm)
• Pediatric Resident PICU Didactic Lectures (Tuesday - Thursday, PICU work room)
• POCUS sessions, led by one of our POCUS-trained faculty (1-2 sessions during elective)

Weekly schedule

Monday	Tuesday	Wednesday	Thursday	Friday
Morning	PICU Rounds	PICU Rounds	PICU Rounds	PICU Rounds	PICU Rounds
Afternoon	Resident Didactic Lecture	Case Conference Fellow Didactic lectures/sim	Resident Didactic Lecture

• The rotation will include both day and evening shifts (weekdays) to provide student with a comprehensive view of pediatric critical care
• Students’ specific schedule will be determined before starting the elective

Method of Assessment

The Directors of the Pediatric Critical Care elective, Dr. Hennigan and Dr. Groves, will compile feedback from the faculty and fellows for the detailed overall evaluation.

Scheduling Information

Duration: 2 weeks

Months Offered: All year

Student point of contact before start of elective: Lakesha Baker to enroll, Lakesha.Baker@NYULangone.org

Dr. Hennigan or Dr. Groves) will be point of contact once enrollment complete

On day 1, students report to: KP 9^th Floor, Pediatric ICU workroom, daily at 7:00AM

• An introduction to the rotation will be emailed to students prior to the start of the rotation. On the first day, students should arrive by 7:00AM to join resident sign-out.
• If needed, you may contact the fellow or attending:
• Fellow on-call: 646-341-1191
• Attending: 347-271-2786

Students per elective block: 1