Child Health Undergraduate Teaching Programme

U N I V E R S I T Y O F L E I C E S T E R

TEACHING PROGRAMME

CHILD HEALTH

2002 - 2003 Block 7

29 April 2002 – 21 June 2002

Department of Child Health

5th floor, Robert Kilpatrick Clinical Sciences Building

Head of Department:Professor M Silverman

Module Director:Dr J Grigg

Undergraduate Co-ordinator:Alison Brown (external tel: 0116 252 3269)

(internal ext: (709)3269)

(NB Mon-Fri, 10.00 am – 1.30 pm)

Tutors: LRIWard 12Dr J Grigg(Airpage: via LRI Switchboard)

Ward 14Dr P Houtman( " " )

Ward 28Dr P Swift/( " " ) Dr K Aminu

Neonatal Unit:Dr Currie

Glenfield:Dr Tofeig (bleep via Glenfield switchboard)

DEPARTMENT OF CHILD HEALTH

STUDENT PLACEMENTS

Block 7:29 April 2002-21 June 2002

1st placement / 2nd placement
GROUP

Orange

/ Dates: / 1.05.02-26.05.02 / 29.05.02-17.06.02
1 / Katinka ANCHERSEN / LRI Ward 12 / Peterborough
Bethan WALSH / " / "
2 / Francisco GUTIERREZ* / " / Coventry
- / - / -
3 / - / - / -
- / - / -
4 / Claire REYNOLDS / LRI Ward 12 / Warwick
Emily O’LEARY / " / "
5 / Leah TONGUE / LRI Ward 14 / Lincoln
Margaret FIELD / " / "
6 / Nikki WALTERS / " / Coventry
Andrew AHYOW / " / "
7 / Rakesh PANCHAL / LRI Ward 28 / Nuneaton
Victoria ST NOBLE / " / "
8 / Rebecca HOPKINS / " / Kettering
- / - / -
9 / Sarah VINCE / " / Burton
Rebecca HIGHTON / " / "
Dates: / 1.05.02-26.05.02 / 29.05.02-17.06.02
10 / Tamsin NEWLOVE / Boston / LRI Ward 12
Steven LEUNG / " / "
11 / Joanna MAKEPEACE / Warwick / "
Ella KEEVASH / " / "
12 / Karnesh PATEL / Peterborough / "
- / - / -
13 / Lauren McCORMICK / Lincoln / LRI Ward 14
Sarah BAILEY / " / "
14 / Rachael CURLEY / Coventry / "
Philippa TURNER / " / "
15 / - / - / -
- / - / -
16 / Floriane SEYDTAGHIA* / Burton / LRI Ward 28
Tinh-Hai COLLET* / " / "
17 / Viren MISTRY / Nuneaton / "
Randeep Kaur JOHAL / " / "
18 / Elizabeth BRADSHAW / Kettering / "
Tajinere FREGENE / " / "

* ERASMUS Students

CHILD HEALTH UNDERGRADUATE TEACHING PROGRAMME

- AIMS AND OBJECTIVES

Aims

Your clinical attachment in Paediatrics and Child Health lasts eight weeks and is based in two different wards, an outpatient setting and, to a lesser extent, the community. The aims of the course are:

1.to provide an introduction to children as patients;

2.to emphasise the importance of growth and development and their interactions with disease;

3.to promote a framework of approach that will enable you to evaluate symptoms and assess children for evidence of disease, to consider possible diagnosis and the need for investigation, and to formulate a plan of management;

4.to increase awareness of the scope for prevention of disease and promotion of health;

5.to encourage curiosity and a questioning approach to the elucidation of problems, thereby contributing to the acquisition of safe and contemporary attitudes throughout your clinical practice.

Objectives

General objectives are listed in the Phase II handbook.

Specific objectives are also given in the Phase II handbook and are set out in detail in your individual Log Book.

Content of course

The initial Introductory Course is designed to help to guide you in history-taking and examination of children. It also provides an introduction to the clinical settings and to the role of play. The Mid-module will help to consolidate the approach to a variety of acute and chronic illnesses that affect children. The Community Medicine block during the final week of the course is described separately.

Ward attachments

Each student will spend time on two wards, one of the children's wards at Leicester Royal Infirmary and another at Peterborough, Lincoln, Nuneaton, Warwick, Coventry, Boston, Burton or Kettering. In each ward in Leicester the Lecturer or the most senior Registrar will act as your tutor. He/she will meet with you at the beginning of your attachment to discuss ward duties, and the prioritisation of options listed on your programme, to advise on project topics and portfolio cases, and to indicate their availability if you need help. The Consultants usually fulfil this role in the out-lying hospitals.

You are expected to complete 4 portfolio cases during the 8-week course, during weeks 2-4 and 6-8. Start as soon as possible so that your cases are completed before the end of weeks 4 and 8 respectively and to give time for feedback and possible modification, before the end of each half-block. You will be assigned a named Consultant with whom to discuss your portfolio cases.

Assessments

A formative examination based around Short Answer questions will be held at 2.00pm on the final Thursday of the course. Results will be available on the Friday morning (see p6 for details).

Other methods of formative assessment include: portfolio cases, presentations in Ward and outpatient settings and a general evaluation by tutors of attitude and attendance. The results will be recorded on the Phase 2 Formative Assessment Form - Child Health. The completed form MUST be returned by you to Dr Grigg/Professor Silverman at the feedback meeting on the final Friday of the block. The original will then be forwarded to the Faculty office, one copy will be retained by the Child Health office and a further copy sent to the student. See p23 for further details of assessments.

Feedback

Group and individual feedback and counselling sessions will be held on the final Friday of your course, starting at 11.00am in Room 104, first floor, Clinical Sciences Building.

INTRODUCTORY COURSE

The following Introductory Course is designed to help orientate the student to history taking and clinical examination in children. It provides, in addition, core information on a variety of acute and chronic illnesses which affect children. Lectures and seminars will be held during the first two days of each module, the dates being as follows: Monday 29 April–Tuesday 30 April 2002; Monday 24–Tuesday 25 June 2002; Tuesday 3 September–Wednesday

4 September 2002; Monday 28 October–Tuesday 29 October 2002; Monday 6 January–Tuesday 7 January 2003.

The venue will be the Seminar Room 104, 1st floor, Clinical Sciences Building, LRI, unless otherwise stated:

DAY 1Monday 29 APRIL 2002 – ROOM 531 csb

09.00-10.30Introduction and

History taking and clinical examinationProfessor C O’Callaghan

10.30-11.00Coffee

11.00-12.30Introduction to community paediatricsDr P Sender

12.30-13.30Lunch

13.45-15.15Normal Development and its assessmentDr W Hoskyns

15.15-15.30Tea

15.30-17.00Resuscitation and life supportDr E Carter

DAY 2TUESDAY 30 APRIL 2002 – ROOM 531 CSB

09.00-10.00Genetics in paediatricsDr M Barrow

10.00-10.30Coffee

10.30-11.30Introduction to neonatal paediatricsDr S Kotecha

11.30-12.30Where do students fit into the system?Dr J Roper

12.30-14.00Lunch

14.00-15.00Growth and its assessmentDr P Swift

15.00-15.15Tea

15.15-16.00The relevance of social science in paediatricsDr A Dolan

16.00-17.30Wards, Play areas, Outpatients etcDr A Oommen, Ms Tina Clegg

CLINICAL TEACHING:

PETERBOROUGH/ LINCOLN/ NUNEATON/ KETTERING/BOSTON/BURTON/ COVENTRY/WARWICK

These details will be given to you separately – travel Tuesday afternoon or very early Thursday morning to arrive by 9.00 am.

MID-MODULE TEACHING

These lectures will be held during the fifth week, Monday and Tuesday, in the Seminar room 104, 1st floor, Clinical Sciences Building, LRI unless otherwise stated, on the following dates: Monday 27-Tuesday 28 May 20021, Monday 22-Tuesday 23 July 2002, Monday 30 September-Tuesday 1 October 2002; Monday 25-Tuesday 26 November 2002; Monday 3-Tuesday 4 February 2003.

DAY 1MONDAY 27 MAY 2002 – ROOM 531 CSB

09.00-10.00RadiologyDr A Rickett

10.00-10.30Coffee

10.30-12.00The relevance of social science in paediatricsDr A Dolan

12.45-14.00Clinical meeting (Room 104, CSB)

14.00-15.30Genetic Case ReviewDr M Barrow

15.30-16.00Coffee

16.00-17.30Skills Fair Paediatric Specialist Nurses

DAY 2TUESDAY 28 MAY 2002 – ROOM 531 CSB

09.00-10.00Congenital heart diseaseDr F Bu’lock

Management of disease:

10.30-11.30AsthmaDr J Grigg

11.30-12.30DiabetesDr P Swift

14.00-15.00Fluid and Electrolyte Disorders Dr P Houtman

15.30-16.30Oncology To be confirmed

FINAL WEEK - 17 JUNE-21 JUNE 2002

MondayLong case assessments at current placements

Tuesday am""""

pm )Community teachingRooms 104/105 CSB

Wednesday am ) " "Rooms 104/105 CSB

pm)" "Rooms 104/105 CSB

Thursday

14.00-16.00Short answer question paper Lecture Theatre CSB

Friday

11.00-13.00Exam results/Feedback session Room 104, CSB

POSTGRADUATE TEACHING ACTIVITIES

All students are welcome to attend Postgraduate teaching activities in the Department:

Monday12.45pm Clinical meetingRoom 104,CSB

Tuesday (1st) 12.30pm Paediatric and Medical PathologyLevel 3, CSB

Thursday1.00pm X-ray meeting(Ward 12 & 14)Ward 14 Sem Rm

Friday9.00am X-ray meeting (Ward 28)Ward 14 Sem Rm

Friday12.15pm Paediatric Surgical X-ray meetingSem Rm, Lev 2,Windsor

Friday(3rd)2.00pm Audit meetingWard 14 or 29 Sem Rm

In addition, there are Clinical Research Meetings at 12.30pm on Wednesdays in Room 531, 5th Floor CSB.

CLINICAL TEACHING, LRI - WARD 12

(including postgraduate meetings)

On the first morning of your LRI attachment (after your Introductory/Mid-module course), please attend CAU at 0840 hours to meet the Ward Manager before going to your ward base.

DAY / am / pm
Mon / 9.00 Outpatients clinic -
Prof Silverman/Dr Grigg (2 students)
11.30 Teaching – Prof O'Callaghan
(meet on Ward 12)
12.45 Clinical meeting
(Room 104, CSB) / 2.00 Outpatients clinic -
Prof O'Callaghan (2 students)
3.30 Neonatal Teaching
Drs Bohin/Kotecha
(Seminar Room, Neonatal Unit)
Tues / 8.30 Post take Ward Round (when on
take)
9.45 Cardiology,Wd 30 Glenfield
- Dr Runciman
(7 May) / 4.00 Neonatal teaching - Professor Field/
Dr Currie
(Seminar Room, Neonatal Unit)
Wed / 9.45 Cardiology,Wd 30 Glenfield
- Dr Tofeig
(29 May)
11.00 Intensive Care – meet at PICU
(22 May, 12 June) / 3.00 Teaching – Dr Hoskyns
(Ward 12)
Thurs / 8.30 Ward Round – Post Take
(Ward 14 Sem Rm)
10.00 Paediatric Surgery – Mr Nour
(16 May, 6 June)
Ward 14 Seminar Room)
11.00 Registrar teaching / 1.00 X-ray meeting,
Ward 14 Sem Rm
4.00 Paediatric Oncology – Dr Shannon
(9 May, 30 May) Ward 27
Fri / 9.00 Teaching - (Ward 12)
Professor Silverman
11.00 Teaching Ward Round - Dr Grigg
Sat / 8.30 Ward Round when on-take

Daily 9.00am ward rounds with Registrar - 2 students urged to attend each day.

NB8.30am mornings after On-Take Day - this is the time for start of important post-take ward round (Seminar Room Ward 14); if you were on duty please attend this round as a priority. At weekends this usually takes place in the Doctors' Office.

CLINICAL TEACHING, LRI - WARD 14

(including postgraduate meetings)

On the first morning of your LRI attachment (after your Introductory/Mid-module course), please attend CAU at 0840 hours to meet the Ward Manager before going to your ward base.

DAY / am / pm
Mon / 9.30 Teaching – Dr D Rutter
11.00 Teaching – Dr Houtman
(Ward 14 Sem Rm)
12.45 Clinical mtg
(Room 104, CSB) / 3.30 Neonatal Teaching
Drs Bohin/Kotecha
(Seminar Room, Neonatal Unit)
Tues / 8.30 Post take Ward Round (when on
take)
9.00 Paed OP clinic – Dr Houtman
(1 student)
11.00 Teaching – Dr E Carter / 2.00 Registrar Teaching
4.00 Neonatal teaching – Professor Field/
Dr Currie
(Seminar Room, Neonatal Unit)
Wed / 8.30 Post take Ward Round (when on
take)
9.45 Cardiology, Wd 30, Glenfield
- Dr Tofeig
(15 May, 4 June)
11.00 Intensive Care – meet at PICU
(8 May, 29 May)
Thurs / 9.00 Paed OP clinic -
Dr Houtman (2 students)
10.00 Paediatric Surgery - Mr Nour
(16 May, 6 June)
Ward 14 Seminar Room) / 1.00 X-ray meeting
(Ward 14 Sem Rm)
4.00 Paediatric Oncology – Dr Shannon
Ward 27 (16 May, 6 June)
Fri / 9.00 Paed OP clinic -
Dr Carter (2 students)
11.30 Ward Round – Dr Holton
Sat / 8.30 Ward Round when on-take

Daily 9.00am ward rounds with Registrar - 2 students urged to attend each day

CLINICAL TEACHING - WARD 28

(including postgraduate meetings)

On the first morning of your LRI attachment (after your Introductory/Mid-module course), please attend CAU at 0840 hours to meet the Ward Manager before going to your ward base.

DAY / am / pm
Mon / 9.00 Outpatients clinic
(Dr Aminu)
9.30 Ward Round – Ward 28
(Dr Green)
12.45 Clinical meeting
(Room 104, CSB) / 2.00 Ward Round – Ward 28 (Dr Aminu)
3.30 Neonatal Teaching
Drs Bohin/Kotecha
(Seminar Room, Neonatal Unit)
Tues / 8.30 Post take Ward Round (when on
take)
9.45Cardiology, Wd 30, Glenfield
- Dr Runciman
(21 May, 12 June) / 2.00 Registrar Teaching
4.00 Neonatal teaching – Professor Field/
Dr Currie
(Seminar Room, Neonatal Unit)
Wed / 9.00 Outpatients clinic LRI
(Dr Elias-Jones)
11.00 Intensive Care – meet at PICU
(15 May, 5 June) / 2.00 Ward Round – Dr Aminu
2.00 Outpatients clinic - Dr Green
Thurs / 10.00 Paediatric Surgery – Mr Nour
(16 May, 6 June
Ward 14 Seminar Room)
11.00 Teaching – Dr M Green / 4.00 Paediatric Oncology – Dr Shannon
(23 May, 13 June)
Ward 27
Fri / 8.30 Post take Ward Round (when on
take)
9.00 Radiology meeting
(Ward 14 Sem Rm)
10.15 Ward Round (Ward 28)
(post-take or consultant round)
Sat / 8.30 Post take Ward Round
(after Friday take)

Daily 9.00am ward rounds with Registrar - 2 students urged to attend each day.

NB 8.30am mornings after On-Take Day - this is the time for start of important post-take ward round (Seminar Room Ward 14); if you were on duty please attend this round as a priority. At weekends this usually takes place in the Doctors' Office.

Specialist Clinics

These are available to all students in rotation. Please sign up on the lists in Ward 14 Seminar Room. They provide the opportunity to see clinical problems which rarely crop up in the acute wards.

Morning

Afternoon

Monday

/ Neurology – Dr Ross/Dr Jay
Cardiology – Dr Bu'Lock (at Glenfield)
Surgical - Mr Fisher/Mr Ninan
Dr Swift – Endocrine/General / Oncology - Dr Shannon

Tuesday

/ Gastroenterology - Dr Green
Cystic Fibrosis – Prof O'Callaghan
Neurology – Dr Holton / Asthma –
Prof Silverman/Dr Grigg
Asthma/Allergy – Dr Luyt
Neonatal - Dr Kotecha
Neurology - Dr Philip
Surgical - Mr Nour

Wednesday

/ Growth/Endocrinology - Dr Swift
Cardiology -
Dr Leanage (at Glenfield) / Renal – Dr Houtman

Thursday

/ Diabetes – Dr Swift
Cardiology -
Dr Tofeig (at Glenfield) / Surgical - Mr Nour
Haematology – Dr Haworth
Neonatal – Prof Field

Friday

/ Dermatology -
Dr Graham-Brown/Dr Nichani
Asthma & Allergy - Dr Luyt / Neonatal - Dr Currie
Rheumatology –
Dr Houtman (3rd+4th Fridays of month)

NBTo sign up for Radiology sessions, please see separate timetable in Ward 14, Seminar Room.

DEPARTMENT OF CHILD HEALTH - Supervisors for portfolio cases

Block 7:29 April 2002-21 June 2002

GROUP
Orange / Dates: / 01.05.02-26.05.02 / Supervisor for
portfolio cases
1 / Katinka ANCHERSEN / Ward 12 LRI / Professor Silverman
Bethan WALSH / " / Dr Luyt
2 / Francisco GUTIERREZ* / " / -
- / - / -
3 / - / - / -
- / - / -
4 / Claire REYNOLDS / Ward 12 LRI / Dr Grigg
Emily O’LEARY / " / Professor O’Callaghan
5 / Leah TONGUE / Ward 14 LRI / Dr Currie
Margaret FIELD / " / Dr Kotecha
6 / Nikki WALTERS / " / Dr Houtman
Andrew AHYOW / " / Dr Carter
7 / Rakesh PANCHAL / Ward 28 LRI / Dr Swift
Victoria ST NOBLE / " / Dr Elias-Jones
8 / Rebecca HOPKINS / " / Dr Green
- / - / -
9 / Sarah VINCE / " / Dr Haworth
Rebecca HIGHTON / " / Dr Shannon
29.05.02-17.06.02
10 / Tamsin NEWLOVE / Ward 12 LRI / Dr Hoskyns
Steven LEUNG / " / Dr Luyt
11 / Joanna MAKEPEACE / " / Professor O'Callaghan
Ella KEEVASH / " / Dr Nichani
12 / Karnesh PATEL / " / Dr Grigg
- / - / -
13 / Lauren McCORMICK / Ward 14 LRI / Professor Field
Sarah BAILEY / " / Dr Kotecha
14 / Rachael CURLEY / " / Dr Houtman
Philippa TURNER / " / Dr Carter
15 / - / - / -
- / - / -
16 / Floriane SEYDTAGHIA* / Ward 28 LRI / -
Tinh-Hai COLLET* / " / -
17 / Viren MISTRY / " / Dr Green
Randeep Kaur JOHAL / " / Dr Heney
18 / Elizabeth BRADSHAW / " / Dr Haworth
Tajinere FREGENE / " / Dr Shannon

*ERASMUS student: this student will not complete a portfolio case.

Students: Please check that your supervisor is available and if not make an alternative arrangement as early as possible in the block.

WARD BASED TEACHING IN THE CHILD HEALTH COURSE

INFORMATION FOR TUTORS AND STUDENTS

Weeks 1 - 3

Objectives:

Orientation to the Wards, Paediatric Outpatients, and the teaching programme.
Learn the approach to sick children - how it differs from adult medicine. To be able to approach an infant, toddler, older child and adolescent, take an appropriate history from the patient/carer, examine the patient with appropriate regard to the age, developmental status and illness of the patient.
Understand the basis of development, know appropriate developmental milestones, undertake a developmental assessment of an infant and a toddler.
Understand the basis of growth, including the effects of puberty. Understand the concept of failure to thrive. Be able to measure and weigh children and infants and plot the results on growth charts.
Understand the multi disciplinary nature of acute paediatrics, and recognise the roles and responsibilities of other health care professionals in the children's hospital.
Carry out a range of basic practical skills (during Nursing Shift)

Responsibilities - Student:

To attend teaching sessions and be pro active in seeing patients on the wards and admissions unit/A & E and OPD.
To ensure that the objectives above are clearly taught and to point out objectives that have not been covered to consultants/tutors.
To record cases and procedures seen in the logbook.
To identify suitable cases for the portfolio, in conjunction with the named tutor.
To plan evening presentations (LRI) with tutor one week in advance.

Responsibilities - Tutor:

To introduce students to the ward and orientate them to the other sections of the Paediatric Service.
To demonstrate history taking and physical examination of infants and children at an early stage in the attachment.
To teach and assess basic developmental assessment of the infant and toddler.
To ensure that students are seeing patients on their 'base ward' (and Ward 27A/28 in LRI), preferably by assessing presentations using structured format provided in the Log Book.
To provide early feedback to students who are having difficulties or who do not appear to be making the most of the opportunities for patient contact offered by the attachment.
To assess portfolio cases, provide feedback and review the revised version (if necessary) before signing the student's Formative Assessment sheet.
To contact the Undergraduate Co-ordinator (Alison Brown: 0116 252 3269 or extn (709)3269) if there are any concerns about a student.

Assessment:

Portfolio cases
Informal assessment by tutor (ward attendance and attitudes).

______

Weeks 5 - 7

Objectives:

To consolidate knowledge and skills gained during weeks 1 and 2.
To learn practical skills outlined in the Log Book.
To learn the basis of the systems approach to the history and examination as it applies to paediatrics.

Responsibilities - Student:

(in addition to those listed above)

To consolidate history taking and systematic physical examination skills, by seeing as many children as possible, and carrying out formal presentations to teaching staff
To identify and remedy any omissions, using the Log Book as guidance.
To complete preparations for the final week assessments: systematic reading; practising "long case" according to the structured format in the Log Book, in particular to demonstrate clinical reasoning in reaching a management plan.
To be familiar with the order and interpretation of appropriate investigations
To improve communication skills with patients, parents, and other staff; to practise giving advice about a number of conditions (listed in the Log Book).

Responsibilities - Tutor:

(in addition to those listed above)

To provide urgent feedback to students who are having difficulties and to contact the Undergraduate Co-ordinator (Alison Brown: 0116 252 3269 or extn (709)3269) if there are any concerns about a student.
To give students an opportunity to perform observed history taking, physical examination, and preparation for their final assessment.

Assessment:

Portfolio cases