Curriculum Objectives
Medical Expert
Demonstrate proficiency in acquiring a complete and accurate paediatric history with consideration of the child’s age, development, and the family’s cultural, socioeconomic and educational background.
Describe differences between the medical management of paediatric patients versus adult patients.
Recognize an acutely ill child.
Demonstrate an approach (the generation of a differential diagnoses, appropriate initial diagnostic investigations, and management plan) to the following core clinical paediatric presentations:
Abdominal Pain & Abdominal Mass
Acutely Ill Child
Adolescent Health Issues
Altered Level of Consciousness
Bruising / Bleeding
Dehydration
Development / Behavioural / Learning Problems
Diarrhea
Edema
Eye Issues
Fever
Genitourinary Complaints
Growth Problems
Headache
Inadequately explained injury
Limp / Extremity Pain
Lymphadenopathy
Mental Health Concerns
Murmur
Neonatal Jaundice
Newborn
Pallor / Anemia
Rash
Respiratory distress / Cough
Seizure / Paroxysmal event
Sore Ear
Sore Throat / Sore Mouth
Vomiting
Well Child Care
Demonstrate physical examination skills that reflect consideration of the clinical presentation as well as the comfort, age, development, and cultural context of the infant, child, or adolescent.
Demonstrate competence with the following paediatric physical examination skills in addition to general physical examination skills:
Position and immobilize patient for certain physical exam skills
Measure and interpret height, weight, head circumference (incl. plotting on growth curve and calc. of BMI)
Measure and interpret vital signs
Palpate for fontanelles and suture lines
Perform red reflex and cover-uncover test
Perform otoscopy
Inspect for dysmorphic features
Elicit primitive reflexes
Perform infant hip examination
Assess the lumbosacral spine for abnormalities
Assess for scoliosis
Palpate femoral pulses
Examine external genitalia
Assess for sexual maturity rating (Tanner staging)
Resources
Bates’ Guide to Physical Examination and History-Taking
Lynn Bickley, Peter G. Szailagi
Lippincott Williams & Wilkins
Textbook of Physical Diagnosis: History and Examination
Mark Swartz
Elsevier Canada
University of Toronto Hub-Paediatrics Well Child Care-Physical Exam Videos
Bates Physical Exam Videos (subscription needed)
Rourke Baby Record
English
French
Greig Health Report: Preventive health care visits for children and adolescents aged 6 to 17 years
Professional
Demonstrate professional behaviours in practice including: honesty, integrity, commitment, compassion, respect and altruism.
Demonstrate a commitment to perform to the highest standard of care through the acceptance and application of performance feedback.
Recognize and respond to ethical issues encountered in clinical practice.
Fulfill legal obligations as they pertain to paediatric practice (reporting child maltreatment).
Recognize the principles and limits of patient confidentiality as it pertains to paediatrics (age of consent, emancipated minors, disclosure of suicidal/homicidal intent, and disclosure of abuse).
Balance personal and professional responsibilities to ensure personal health, academic achievement, and the highest quality of patient care.
Recognize factors such as fatigue, stress, and competing demands/roles that impact on personal and professional performance. Seek assistance when professional or personal performance is compromised.
Resources
CMA Code of Ethics and Professionalism
Summary of virtues exemplified by the ethical physician, fundamental commitments of the medical profession, and professional responsibilities. Excellent pictorial review.
CFMS position statement on professionalism adapted from CanMEDS 2015.
How to ask for and act on feedback: practical tips for medical students
Medical decision-making in paediatrics: Infancy to adolescence
A review of the ethical principles around decision-making in paediatrics including provincial laws around age of consent and advance directives.
Child Maltreatment: A “What to Do” Guide for Professionals Who Work With Children
Primer on duty to report for suspected child maltreatment including diagnosing, legal implications, prevention and intervention, and implications for practitioners.
Age of consent for sexual activity and duty to report
CMPA summary of Canadian law around age of consent for sexual activity and duty to report.
CFMS: Wellness
Outstanding CFMS resource on student wellness with numerous relevant modules.
Communicator
Demonstrate communication skills that convey respect, integrity, flexibility, sensitivity, empathy, and compassion.
Communicate using open-ended inquiry, listening attentively and verifying for mutual understanding.
Demonstrate a patient-centered and family-centered approach to communication which requires involving the family and patient in shared decision making, and involves gathering information about the patients’ and families’ beliefs, concerns, expectations and illness experience.
Acquire and synthesize relevant information from relevant sources including: family, caregivers, and other health professionals.
Demonstrate organized, complete, informative, legible, and accurate written/electronic information related to clinical encounters (such as: admission histories, progress notes, and discharge summaries).
Demonstrate clear, legible, and accurate ‘doctors orders’ (such as investigations, medication orders and outpatient prescriptions).
Demonstrate organized, complete, informative and accurate information in verbal patient presentations.
Respect patient confidentiality, privacy and autonomy.
Acknowledge/demonstrate the principals of dealing with challenging communication issues including: obtaining informed consent, delivering bad news, disclosing adverse medical events, and addressing anger, confusion, and misunderstanding.
Resources
Collaborator
Work effectively, respectfully, and appropriately in an inter-professional healthcare team.
Demonstrate understanding of roles and responsibilities in an inter-professional health care team; recognizing his/her own responsibilities and limits.
Effectively collaborate/consult/participate with members of the inter- and intra-professional team to optimize the health of the patient/family.
Effectively work with other health professional to prevent, negotiate, and resolve inter- and intra-professional conflict.
Resources
CPS
Position statement on specific role of paediatricians in coordinated approach to care.
Queens Online Learning Module
Online Learning module of collaborator role by Queen’s University
Collaborative Care: A Medical Liability Perspective
Collaborative Care Summary article from CMPA
Collaborative Care Summary
Article from CMPA on collaborative care specifically with a medical liability perspective.
Articles on how to critically appraisal different types of studies/articles:
Critical Appraisal Checklists
EBM Tools
Leader
Demonstrate priority setting, and time management skills that balance patient care, academic responsibilities, and personal well being.
Employ information technology to maximize patient care.
Demonstrate a rationale approach to finite resource allocation in patient management; apply evidence in cost-effective care.
Develop management plans that demonstrate due attention to discharge planning, and recognition of key community resources to support the family once out of hospital.
Health Advocate
Engage in advocacy, health promotion and disease prevention with patients and families including: mental health, child maltreatment, healthy active living, safety, and early literacy support.
Identify emerging and ongoing issues for paediatric populations who are potentially vulnerable or marginalized including: First Nations People, new immigrants, children with disabilities, children living in poverty, and children with gender identity, sexual orientation, or mental health concerns.
Identify determinants of health for paediatric populations and the physician’s role and points of influence in these issues.
Identify barriers that prevent children from accessing health care including: financial, cultural, and geographic.
Resources
Canadian Paediatric Society – Policy & Advocacy -> Advocacy Center
Provides a tool kit for how to advocate, links to advocacy tools and specific initiative the CPS has undertaken
CanMeds Health Advocate Role:
Royal College definition and description of the health advocate role
CMPA: The physician voice: When advocacy leads to change
Canadian Medical Protection Agency view and tips on physician advocacy
CFMS Advocacy Toolkit
Advocacy toolkit developed by the Canadian Federation of Medical Students. Includes links to position papers.
The Health of Canada’s Children and Youth
Provides graphs and tables on the health and wellbeing of Canadian children. Contains specific modules on at risk population (Indigenous children, Refugee and Immigrant Children).
Advocacy and the Paediatrician
Article providing case scenarios of paediatric advocacy at work
Waterson, T and Haroon, S. Advocacy and the Pediatrician. Paediatrics and Child Health 18(5): 213-218, 2008 (PDF)
PedsCases: Advocacy 101 – Series of 3 podcasts on creating an advocacy project
Part 1: Generating a “Good” Idea
Part 2: Designing and Planning Your Project
Part 3: Implementing and Evaluating Your Project
Scholar
Engage in self-directed lifelong learning strategies.
Engage in self assessment through reflective practice.
Apply the principals of critical appraisal of the literature to guide evidenced based patient care.
Demonstrate integration of new learning into practice.
Demonstrate effective teaching/learning strategies and content that facilitate the learning of others (peers, patients, families, allied health professionals).
Resources
Articles on how to critically appraisal different types of studies/articles:
Critical Appraisal Checklists
EBM Tools