Patient Encounter Form (to be used as a guide – all encounters need to be logged in CLEX Journal)

Types of Patients to be Seen / Minimum Number Required for Clerkship / Requirement Completed? / Expected Location of Patient Encounter
Domain-patient type/core condition / Examples of diagnosis or issue addressed
Health Maintenance / Newborn (0-1 mo) / 10 / Nursery
Infant (1-12 mo) / 3 / PCC
Toddler (12-60 mo) / 3 / PCC
School age (5-12 yrs) / 2 / PCC
Adolescent (13-19 yrs) / 1 / PCC
Behavior / Sleep problems, colic, temper tantrums, toilet training, feeding problems, enuresis, ADHD, encopresis, autistic spectrum disorder, eating disorders, head banging, poor school performance / 2 / PCC or Inpatient
Central nervous system / Meningitis, concussion, seizures, ataxia, closed head injury, headache / 4 / PCC or Inpatient
Chronic medical problem / Seasonal allergies, asthma, cerebral palsy, cystic fibrosis, diabetes mellitus, malignancy (e.g. acute lymphocytic leukemia or Wilms tumor), sickle cell disease, epilepsy, atopic dermatitis, obesity, sensory impairment, HIV/AIDS, renal, congenital heart disease. / 5 / PCC or Inpatient
Dermatologic system / Viral rash, scarlatina, eczema, urticaria, contact dermatitis, toxic shock, thrush, atopic dermatitis, seborrheic dermatitis, acne, anemia / 4 / PCC or Inpatient
Development / Delayed or possibly delayed language, gross motor, fine motor, or social adaptive skills / 2 / PCC
Emergent Clinical Problem / Meningitis, shock, testicular torsion, DKA, SIDS, acute life threatening event (ALTE), congestive heart failure, burns, status asthmaticus, status epilepticus, encephalitis, child abuse etc. / 5 / PCC or Inpatient
Gastrointestinal Tract / Gastroenteritis, giardiasis, pyloric stenosis, appendicitis, HSP, peptic ulcer disease, gastroesophageal reflux disease. / 9 / PCC or
Inpatient
Growth / FTT, poor weight gain, obesity, short stature, microcephaly, macrocephaly, constitutional delay, small for gestational age, large for gestational age / 3 / Inpatient, PCC or Nursery
Lower Respiratory Tract / Bronchiolitis, bronchitis, pneumonia, aspiration, asthma, bronchiectasis / 8 / PCC or Inpatient
Nutrition / FTT, breast vs. formula feeding, questions about switching to formula, when to add solids, beginning cow's milk, diet / 4 / Inpatient, PCC or Nursery
Unique condition: fever without localizing findings / Rule out sepsis, urinary tract infection, systemic viral infection (e.g. EBV), autoimmune diseases / 5 / PCC or Inpatient
Upper Respiratory Tract / Pharyngitis, strep throat, viral URI, herpangina, peritonsillar abscess, common cold, allergic rhinitis, otitis media, sinusitis, otitis externa / 5 / PCC or Inpatient

The minimum number of patients listed on this page must be logged into CLEX Journal in order to receive full credit for your rotation. To qualify for credit, the responsibility you will have for these patients must be either full participation (a patient of your own and presented on) or partial participation (a patient your team discussed). If you have difficulty fulfilling any of the required domains, you may complete an alternative learning experience such as a CLIPP Case, an additional reading or a lecture and enter the experience into CLEX as an A.L.E.

Patient Encounter Form (to be used as a guide)

Required Procedures / Minimum Number Required for Clerkship / Requirement Completed? / Expected Location of Patient Encounter
Bilirubin--Interpret / 1 / PCC or Nursery
CBC-Interpret / 1 / Inpatient, PCC or Nursery
Circumcision- Observe / 2 / Nursery
CXR-Interpret / 1 / Inpatient or PCC
Deliveries---Observe / 2 / Nursery/NICU
Growth Chart--Perform / 1 / PCC
Hearing Screen-Interpret / 1 / PCC or Nursery
Immunizations--Observe / 1 / PCC
Lead Questionnaire--Interpret / 1 / PCC
LP Findings--Interpret / 1 / Inpatient
Newborn Screen-Interpret / 1 / PCC or Nursery
PEDS Questionnaire--Interpret / 1 / PCC
Rapid Strep-Interpret / 1 / PCC
Vision Screen-Interpret / 1 / PCC

The minimum number of procedures listed on this page must be logged into CLEX Journal in order to receive full credit for your rotation. To receive credit, you must have observed, Interpret or performed the procedure. )

If you have difficulty fulfilling any of the required domains, you may complete an alternative learning experience (A.L.E.) such as a CLIPP Case, an additional reading or a lecture and enter the experience into CLEX as an A.L.E.