Fellows will deal with patients of all pediatric age groups as well as adults with congenital heart disease in the variety of clinical settings at Rush University Children’s Hospital, based upon specific rotation. This will include providing care for patients in the following areas:
Fellows will be supervised by pediatric cardiology faculty members on service in the variety of rotations. Faculty members are on service and call for one week at a time. Faculty members will be involved in all aspects of fellow learning during all rotations. Faculty members are responsible for patient care and supervising all fellows’ activities during their training. In supervising fellows, the following measures are followed:
Fellows will learn the following aspects of patient care in all rotations:
Throughout the years of fellowship, fellows attend structured didactic teaching 3 times per week. A total of 130 lectures are given every year. Attendance of all lectures is monitored and mandatory regardless of clinical responsibilities. Fellows are expected to attend at least 80% of all lectures.
In addition to the didactic lectures outlined above, the clinical rotations have built in teaching provided through the following venues:
One-on-one learning sessions with supervising faculty member. This is delivered during rounds and/or thereafter during the day. Each week will provide three learning sessions. These learning sessions will include the following topics:
Case scenarios and multiple choice questions for case scenarios. These are provided through online educational website to be completed by fellows throughout clinical rotation
Reading materials include:
To achieve a lifelong habit of practice, the following aspects are built into each inpatient rotation:
During inpatient rotation, fellows are instructed and then assessed by supervising faculty on the use of available technology for patient care and education. Specific examples are:
An online learning tool provides the opportunity for fellows to accomplish critical self learning. The online module contains clinical cases spanning the full spectrum of education in pediatric cardiology. These case scenarios test fellows’ knowledge, critical thinking, as well as awareness of professional standards and impact of care on patient as whole, such as long term care, cost of care, etc.
Fellows will prepare, under supervision of assigned faculty member for the section’s monthly morbidity and mortality conference. Fellows will present cases and discuss factors leading to M&M and possible alternative means through which this could have been avoided.
Fellows will present patients in-house during the weekly multidisciplinary patient discussion conference under the supervision of faculty member on service. Presentation will include patient history, diagnosis, results of investigative studies, diagnosis and therapeutic course.
Fellows rotate in assuming responsibility for this monthly activity. A faculty member is assigned to supervise these sessions. Fellows assigned to this activity choose, after discussion with faculty member, 2-3 articles for the monthly conference. Fellows, after review of articles, present the articles chosen; indicate strengths and weaknesses in methodology, analysis and conclusion. Fellows also indicate other articles published within the past five years which support or refute findings in articles discussed. Journal club conferences are attended by all pediatric cardiology fellows and faculty members. Attendance is recorded.
Supervising faculty members choose a clinical scenario from actual patient cases during each clinical rotation to stimulate fellows to correlate evidence based published research to clinical care provided. Fellows search the medical literature available through the medical library online Medline system (Ovid). An article is chosen in consultation with the supervising faculty, and then the fellow is requested to provide the following in a verbal report:
The case scenario and article chosen must be entered by faculty member in fellows’ rotation evaluation.
Access to the online Medline system (Ovid) is taught to fellows during a didactic lecture at the beginning of each academic year by one of the medical school’s librarians. Available online resources, establishing access through the internet and navigating these systems are covered; in addition, means of requesting further help through the library system is provided to fellows through this orientation.
The following areas of communication are taught, monitored and evaluated during clinical rotations:
Faculty members serve as models of effective communication with patient/families and other health professionals during daily rounds. Faculty members outline after rounds important and new issues concerning communications. As fellows advance in levels of training, they are requested by faculty members to conduct rounds in the presence of faculty members to observe, assess and critique verbal communication skills of fellows. Critique is conducted discreetly between faculty members and fellows after conclusion of rounds.
Written communication: fellows are requested to formulate daily progress and consult notes for patients. These reports are reviewed, assessed and critiqued by supervising faculty members during daily sessions.
Special circumstances: complaints and praises made regarding fellows are discussed with fellows by supervising faculty member. Concerns of significant impact are reported to program director.
Lectures addressing medical ethics and professionalism are provided annually to pediatric cardiology fellows through the department of pediatrics. In addition, professionalism is taught, observed, assessed and critiqued through the following venues during clinical rotations:
Patient care while in the hospital is put into context of patient care pre-admission, particularly as it relates to prevention and post discharge from hospital as it relates to family’s environment, understanding of disease and cost of medical care. These issues are discussed during rounds, patient care conferences and upon discharge. Fellows are assessed in this aspect as they are able to relate these issues in their notes and presentation of patients during patient care conferences. Rotation evaluations assess this aspect of training.
Incidents of morbidity and mortality must be discussed by faculty member and fellows involved. Patient medical background, steps leading towards unwanted consequences as well as how such complications should be spotted and reversed is discussed and later presented through a multi-disciplinary conference. Fellows and supervising faculty member present data to this conference.
Fellows participate in patient care meetings as well as faculty meetings to address issues relating to structure and procedures within this discipline of patient care. Fellows are encouraged to suggest alternative methodologies.
The following guidelines, consistent with the ACGME’s common program requirements, delineate the policy that the Rush University Pediatric Cardiology Fellowship Program will adhere to:
Every effort will be made by the program director, faculty and trainees to maintain strict compliance with the above guidelines. This policy is disseminated yearly to all program faculty and staff.
Violations of above policy must be reported though one or all of the following 3 mechanisms: