Pediatric Preclerkship Strategies and Recommendations

Goals:   During the preclerkship curriculum, all medical students, regardless of ultimate career choice should:

  1. Participate in the care of patients of all ages in order to gain a foundational  understanding of pediatric health and disease processes
  2. Experience pediatric conditions embedded into the basic science curriculum
  3. Gain exposure to children of various ages and their families to enhance communication and physical exam skills

Objectives 

  • examples of possible associated educational strategies to choose from for each objective are listed below the objective:
  1. Comprehend pediatric clinical content in the context of basic science learning

a. Pediatric faculty are present and content is included within basic science blocks/courses. 

Examples:

      1. Pediatric faculty present certain conditions and can discuss how these conditions may vary across the age spectrum
      2. Identify high yield pediatric USMLE Step 1 content
      3. Pediatric picture or case of the week activities
      4. Cross check core conditions in Core COMSEP curriculum to be included

b. Paid time/support for a preclerkship pediatric content director.

Examples: 

      1. Faculty member with overview responsibility of pediatric preclinical curriculum
      2. Pediatric clerkship director working together with pre-clerkship course directors to identify where content can be mapped out 

c. Development of modules with pediatric patients 

d. Integrating embryology within anatomy course

e. Pediatric considerations (e.g. weight based dosing) in pharmacology course 

f. Superblock of pediatrics/child development/life cycle

g. Flipped Classroom/Readings/Articles/Videos

 

Assessment Strategies:

(Exam, MCQs, USMLE Step 1 breakdown of pediatric material,  Small Group participation, e.g. PBL/cases, short answer questions)

   2. Practice pediatric physical exam maneuvers with age appropriate techniques on different age groups

    1. Small group (if possible) teaching session on relevant age appropriate physical exam
    2. Standardized patients or direct practice with children of different ages and developmental stages 
      1. home-schooled children
      2. nursery schools/daycares
      3. elementary/middle/high schools
      4. faculty/resident children
    3. In the preceptor visit curriculum including pediatricians
      1. longitudinal continuity with a pediatric preceptor
      2. deliberate exposure to a pediatric practice 
    4. Newborn nursery clinical experiences
    5. Deliberate practice of pediatric growth and development (eg growth charts, developmental milestones)
    6. Recognition of normal variations of vital signs on children of different ages, including growth parameters
    7. Pediatric boot camp prior to clerkship
      1. Physical exam workshop and skills night
    8. Videos (eg developmental milestone videos)

 

Assessment Strategies:

(Direct Observation, Checklist, Passport, Short Answer questions, MCQ questions, e.g. on vitals and growth, OSCE)

     3. Recognize the different components of and approaches to a pediatric history on different age groups

    1. Small group (if possible) teaching session on relevant age appropriate history (eg. adolescent psychosocial, birth history in newborn)
    2. Standardized patients or direct practice with children of different ages and . developmental stages 
      1. home-schooled children
      2. nursery schools/daycares
      3. elementary/middle/high schools
      4. faculty/resident children
    3. In the preceptor visit curriculum including pediatricians
      1. longitudinal continuity with a pediatric preceptor
      2. deliberate exposure to a pediatric practice 
    4. Newborn nursery clinical experiences
    5. Pediatric boot camp prior to clerkship
    6. Role Plays with common pediatric history scenarios

 

Assessment Strategies:

(Direct Observation, Checklist, Passport, Short Answer questions, small group participation, OSCE)

     4. Practice communication with a child and his/her caregiver

    1. Standardized patients or direct practice with children of different ages and developmental stages 
      1. home-schooled children
      2. nursery schools/daycares
      3. elementary/middle/high schools
      4. faculty/resident children
    2. In the preceptor visit curriculum including pediatricians
      1. longitudinal continuity with a pediatric preceptor
      2. deliberate exposure to a pediatric practice 
    3. Role Plays
      1. Counsel on nutrition, activity, safety, and other…
    4. Practice Motivational Interviewing/Healthy lifestyle habit
      1. HS students interested in medicine as standardized patients, parental smoking cessation, regular exercise and healthy diet, and other…

 

Assessment Strategies:

(Direct Observation, Checklist, Passport, Short Answer questions, Peer Feedback, Standardized Patient Feedback, Self Assessment, OSCE)

    5. Recognize there are different preventative medicine strategies for children according to age  

    1. Teaching sessions (ideally small group or workshop format) emphasizing healthy pediatric practices that can prevent adult illness
    2. Service Learning activities
    3. Newborn nursery clinical experience (observing counselling)
    4. Practice Motivational Interviewing 
      1. HS students interested in medicine as standardized patients, parental smoking cessation, regular exercise and healthy diet, and other…
    5. Flipped Classroom/Readings/Articles/Videos
    6. Quality Improvement Opportunities in Preventive Care
    7. Role Plays
      1. Counsel on nutrition, discipline, immunizations, safety, etc

 

Assessment:

(MCQs, Small Group participation, e.g. PBL/cases, short answer questions)

     6. Identify barriers to healthcare and the community and healthcare team resources available for children and families 

    1. Teaching sessions (ideally small group or workshop format) emphasizing socioeconomic determinants of health in children
    2. Scavenger Hunt—Walk around the city scavenger hunt/observe – obesity prevention; grocery/pharmacy; baby stores, etc—for particular developmental levels)
    3. Population based learning (eg Photovoice projects)
    4. Service Learning
      1. Compile/identify all pediatric related advocacy/service opportunities in your institution
    5. Current Event discussion
    6. Sharing of Community Resources for Kids

 

Assessment Strategies:

(Small Group participation, e.g. PBL/cases, short answer questions, reflection, essay, portfolio)