McMaster ANESTHESIA Residents

Welcome to the Pediatric Surgery service! The Pediatric Surgery rotation is an opportunity to become familiar with the diagnosis, initial management, and perioperative care of surgical conditions in neonates, infants, and children up to the age of 18 years. During this rotation, residents will be under the direct supervision of the pediatric surgery fellows and staff, will take first call to assess emergency consultations, and will gain surgical experience in the operating room. The focus is on gaining comfort with pediatric surgical problems, working with a team, and communicating with families.

Summary of Assessment Requirements – collect in your Educational Portfolio

It is your responsibility to arrange an introductory orientation meeting with your Mentor within the first week of the rotation. KEEP THIS FORM WITH YOU.

Your name: …………………………………………………Dates of your rotation: ………………………………………………………….

Your faculty Mentor is: ………………………………………………………….

Orientation with Mentor?DATE: ………………………Signature: ………………………………..

………………………………………………………………………………………………………………………………………………………………….

Arrange a meeting with your Mentor after the first week of the rotation to review your progress, raise any concerns, and reinforce your learning objectives. These assessments should be completed and reviewed with your mentor.

1360 Evaluation (form is from the Anesthesia program)

2-3 completed dictations (print out consult, discharge summary, and/or OR notes)

Review by Mentor: DATE: ………………………Signature: ………………………………..

Comments:

………………………………………………………………………………………………………………………………………………………………….

All residents MUST SUBMIT all required assessments to your Mentor at the End of rotation, WITH THIS FORM, and meet with your Mentor to complete the Final In-Training Evaluation Report (ITER).

(Keep copies for your own Educational Portfolio and submit to your Program Director as required)

Assessments to be submitted:

3 - 360 Evaluations.

Rounds presentation evaluation summaryTOPIC?…………………………………….

Self-evaluation using the ITER form.

Final meeting with Mentor: DATE: ………………………Signature: ………………………………..

Summary Comments: (to be added to ITER).

FINAL ITER ENTERED INTO WEBEVAL:DATE: ………………………Signature: …………………………..

Pediatric Surgery Rotation Specific Objectives for ANESTHESIA Residents

(relevant core knowledge highlighted)

Medical Expert: Core knowledge

By the end of the rotation, the resident should have the necessary basic science and clinical knowledge to:

Recognize normal pediatric vital signs for various age groups, and understand the relevant anatomy and cardiovascular/respiratory physiology of infants and children.

Identify the preoperative anesthetic considerations for common pediatric surgical presentations such as appendicitis, bowel resection, pyloric stenosis, foreign body swallowed or aspirated.

Review the intraoperative principles of managing pediatric patients, including temperature control, fluid management, airway considerations, narcotic dosing and pharmacology, and glucose metabolism.

Manage pre and postoperative care including: NPO guidelines (clear fluids, breast milk, cow’s milk, formula, solid food), fluids/electrolytes, intravenous nutrition, pain management (rectal acetaminophen, narcotics, NSAIDs, caudal blocks, considerations for using PCA), antibiotics,pediatric drug dosing, and central lines.

Medical Expert: Psychomotor skills

During the pediatric surgical rotation, the anesthesiaresident is expected to demonstrate aseptic technique, learn to recognize surgical anatomy and pathology, and gain proficiency assisting and doing some pediatric surgery procedures. There will be opportunities in the operating room to gain experience with intravenous insertion and intubation.

Communicator: The resident must be able to obtain a relevant history from children of all ages, involve children in decision making as appropriate, share medical information with families, and recognize the ethical implications of communicating with interpreters and substitute decision makers including social workers and Children’s Aid.

The resident will convey pertinent clinical information succinctly to other physicians verbally, over the phone, in written and dictated notes, and to the team during signover and the weekly case conference.

Collaborator: The resident will work closely in collaboration with other members of the surgical team including medical, nursing, and paramedical health professionals.

Manager: The resident will assess patients efficiently, and manage the multiple clinical demands of the ward, operating room, clinic and emergency department. The resident will manage the ward patients including supervising students on the team, delegation and followup management tasks.

Health Advocate: The resident will identify public health aspects of surgical conditions that are amenable to preventive efforts, and ways in which anesthetists can have an impact on reducing surgical complications to improve long-term outcomes.

Scholar: The resident will demonstrate a curiosity and initiative in identifying the best evidence-based management of surgical conditions they see. During the rotation the resident will present a case-based topic at Pediatric Surgery Rounds, and may have an opportunity to participate in a research project.

Professional: The resident will be punctual attending ward rounds, timely in completing dictated notes, and considerate of other team members when leaving their duties. Requests for vacation and time-off will be negotiated in a professional manner with the senior team members.

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Rev June 2015 - BC