Ambulatory Care Rotation I: Pediatric Behavior and Development
The Developmental Behavioral Pediatrics Rotation is a 4-week clinical rotation in Developmental and Behavioral Pediatrics and Child and Adolescent Psychiatry. It includes a combination of clinical experiences and didactic seminars. The purpose of the rotation is to provide an introduction to and understanding of the following:
- Normal Child and Adolescent Development
- Behavioral Medicine: Office assessment and management of selected issues and problems in clinical practice. This seminar will cover basic problems in sleep, feeding and other normal biological functions. It will also cover core management issues in elimination disorders, pain management and dealing with the behavioral aspects of chronic pediatric illness and psychosomatic disorders.
- Assessment and Treatment of Psychopathology in outpatient pediatric practice. This seminar will address disruptive behavior disorders (ADHD, Conduct and Oppositional Defiant Disorders), mood disorders (Depression, Bipolar Disorder and Suicide); anxiety disorders (phobias, Social Phobia, Panic Disorder, Separation Anxiety Disorder, and PTSD); and substance abuse disorders. Residents will also learn to use the PSC in the office.
- Developmental Disabilities and Pervasive Developmental Disorders at LADDERS (Learning and Developmental Disabilities Evaluation & Rehabilitation Services), a multidisciplinary center for specialty care for children with a wide range of developmental problems.
- Principles of pediatric psychopharmacology
These areas will be taught in didactic seminars at MGH and through clinical rotations in a variety of settings, working with members of a multidisciplinary team. The primary settings and leaders will be:
- LADDERS (Dr. Bauman)
- Healthy Steps (Jennifer Bronsdon and Susan Curley)
- McLean Adolescent Residential and Partial Hospital Treatment Program (Dr. Rater and Staff)
- Acute Psychiatric Service (Dr. Prater)
I. Patient Care
II. Medical Knowledge
III. Practice-Based Learning and Improvement
IV. Interpersonal and Communication Skills
V. Professionalism
VI. Systems-Based Practice
I. Patient Care
- Use a logical and appropriate clinical approach to the care of children who present with developmental and behavioral concerns, applying principles of evidence-based decision-making and problem solving.
- Provide sensitive support to children who present with developmental and behavioral concerns, and their families.
II. Medical Knowledge
- Demonstrate a commitment to acquiring the knowledge needed in developmental and behavioral pediatrics.
- Know and/or access medical information efficiently, evaluate it critically, and apply it appropriately to care of children and families dealing with developmental and behavioral concerns.
III. Interpersonal and Communication Skills
- Communicate skillfully with families and children and provide appropriate patient education and reassurance for conditions common to developmental and behavioral pediatrics.
- Communicate effectively with physicians, psychologists, developmental specialists, and other health professionals, and health related agencies to create and sustain information exchange and team work for patient care.
- Maintain accurate, legible, timely, confidential and legally appropriate medical records in this clinical setting.
IV. Practice-based Learning and Improvement
- Use scientific methods and evidence to investigate, evaluate, and improve patient care practice related to developmental and behavioral issues.
- Identify personal learning needs, systematically organize relevant information resources for future reference, and plan for continuing acquisition of knowledge and skills.
V. Professionalism
- Demonstrate personal accountability to the well being of patients (e.g., writing comprehensive notes, and seeking answers to patient care questions).
- Demonstrate a commitment to professional behavior in interactions with staff and professional colleagues.
- Adhere to ethical and legal principles, and be sensitive to diversity.
VI. Systems-Based Practice
- Identify key aspects of health care systems as they apply to care of individuals and their families dealing with mental health, behavioral or developmental concerns, including timely access to subspecialty evaluation and treatment, cost control, billing, and reimbursement.
- Demonstrate sensitivity to the costs of clinical care for patients who present with developmental or behavioral concerns, and take steps to minimize costs without compromising quality.
- Recognize and advocate for families who need assistance to deal with systems complexities and identify resources to meet their needs.
- Recognize the pros and cons of different practice structures to assess development and deliver anticipatory guidance in primary care settings.
- Recognize the limits of one's knowledge and expertise and take steps to avoid medical errors.
