Ambulatory Care Rotation III: Adolescent Medicine
The experience in adolescent medicine is a 4-week block rotation for 3rd year residents taught by a multi-disciplinary staff of adolescent health providers in a wide variety of settings. Settings included adolescent focused primary care practices, tertiary care center adolescent and gynecology clinics, and community based experiences. On this rotation, residents also participate in small group discussions about topics relevant to ambulatory pediatrics for one-half day per week. These sessions are led by a faculty member and include residents on other ambulatory rotations. The objectives of this rotation are designed to further the residents’ competency in the following six areas, as it relates to adolescent medicine:
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 adolescents, applying principles of evidence-based decision-making and problem solving.
- Provide sensitive support to adolescents and their families in all clinical settings (outpatient, continuity, adolescent clinic, mental health services, inpatient hospital services).
- Describe the following procedures, including how they work and when they should be used; competently perform those commonly used by the pediatrician in practice.
- Gynecologic Evaluation
- Urethral Swab
- Genital Wart Treatment
- Scoliometer
- Adolescent immunizations
II. Medical Knowledge
- Demonstrate a commitment to acquiring the base of knowledge needed for care of adolescents, including:
- Psychosocial development
- Health supervision for adolescents related to education, school performance, and school-related behaviors
- Understand health supervision related to adolescent injuries, including substance abuse, sports participation, and safety practices.
- Understand health supervision for adolescents related to sexual issues.
- Understand health supervision for adolescents related to tobacco and substance abuse
- Performing mental health screening, including depression and suicide.
- Know and/or access medical information efficiently, evaluate it critically, and apply it to adolescent care appropriately.
III. Interpersonal and Communication Skills
- Communicate skillfully with adolescents and their families, using effective interview, counseling and patient education strategies.
- Communicate effectively with physicians, other health professionals, and health related agencies to create and sustain information exchange and team work for patient care.
- Develop effective strategies for teaching students, colleagues, other professionals and lay persons.
- Maintain accurate, legible, timely, confidential and legally appropriate medical records and consultation reports for adolescents in the outpatient and inpatient setting.
IV. Practice-based Learning and Improvement
- Identify standardized guidelines for diagnosis and treatment of conditions common to adolescents and adapt them to the individual needs of specific patients.
- Use scientific methods and evidence to investigate, evaluate, and improve one's patient care practice related to adolescents.
- Identify individual learning needs, systematically organize relevant information resources for future reference, and plan for continuing acquisition of knowledge and skills related to adolescents.
V. Professionalism
- Demonstrate personal accountability to the well being of patients (e.g., following-up lab results, 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 of care; demonstrate appreciation of and understanding of issues pertinent to adolescents (treatment of minors, confidentiality, etc.)
- Be sensitive to diversity and recognize one's own biases that may affect one's response to adolescents
VI. Systems-Based Practice
- Identify key aspects of health care systems as they apply to care of adolescents and their families (e.g., challenges to access and continuity of care; factors affecting billing and reimbursement).
- When providing care to adolescents in all clinical settings, consider cost and resource allocation without compromising quality of care.
- Recognize and advocate for adolescents who need assistance to deal with health care systems complexities.
- Recognize the limits of one's knowledge and expertise and take steps to avoid medical errors.
