Introduction to

Child Health
MSc DTCH

E.O.D. ADDO-YOBO MD FGCP MWACP 11TH SEPTEMBER 2008

Introduction

Paediatrics = the branch of medicine dealing with the development and care of infants and children, and with the treatment of their diseases, illnesses, etc. Child Health = the broader sense including preventive aspects Forms Part 1B of MB CHB Examinations

Course Objective

To Understand, and be able to Recognise, and appropriately manage through the use of requisite skills, a broad range of common childhood medical problems, as found both in the clinic and in the community (especially in Ghana), on a basis of sound medical principles.

Training Activities

Lectures: 1-2 hours [08:00-10:00] - Tues, Thurs, (Fri).

Clinical work: Predominantly individual: Personal involvement in patient care at all stages: (For REST OF DAY) Clerking (History taking) Examination Forming Impressions Differential diagnosis [Individual reading around case/Case discussions] Conducting Appropriate Procedures/Investigations Synthesis of data Making Appropriate diagnosis/differentials Initiate management Conduct preliminary investigations and treatment/counsel. Appreciate dangerous situations and manage, consult or refer (abilities and limitations Safe Practice)

Case discussion at various levels

Learning Processes

Daily participation in teams activities apprenticeship.

Clinical discussion of cases Individual initiative Observe and Perform procedures Evaluate the effectiveness of management plans through proper recording and periodic assessment of the patients progress Communicate with other members of health team as indicated Ward rounds Presentation of cases

Bedside Teaching Small Group Tutorials Student Seminars (Senior clerkship)

Rotations
Wards/Subspecialty Units:

B4 - Malnutrition/Nephrology B5 Haematology/Oncology C5 Cardiology/Pulmonology PEU Emergency Care MBU Neonatology

All deal with Infectious diseases

Programme
Clerkships: Junior Clerkship

Primary acquisition of skills

Community Health District Posting

Senior Clerkship Consolidation of skills

Rotation cycle:
MBU B4

C5

PEU

B5

Examinations/Assessments

Continuous Assessment/Group Assessment [30% FINAL SCORE ]

General attendance /Day to day performance (Log Book Entries) End of Rotation Exams End of Junior clerkship assessment Post District Exams (MCQ) Mock (Senior Clerkship Exam)

Final Examinations (MB ChB Part 1B) at end of Programme 70% FINAL SCORE Theory & Oral -50% Clinical 50%: Obligatory pass

Log Book

Log Book -2

Recent Passport size picture

Students Signature..

Log book Introductory Notes

The logbook is a record of important activities that should be covered by the student during the clerkship in Child Health. It is the evidence that the student has worked consistently and diligently under supervision during the rotation and has acquired a minimum of skills that make him/her eligible for the final examinations and certification in Child Health. The logbook will be evaluated periodically and at the end of the course. This evaluation will form a major part of the Continuous Assessment of the student during the course, and will contribute toward the overall score for the final Mb ChB Part 1B examination in Child Health.

Notes on using log book-1

The emphasis of the logbook entries is supervised teaching and gradual learning on a weekly basis leading to mastery. Students must sign in on entering a team/rotation and sign out on leaving the team/rotation.

Entries should be made only after discussions with the Supervising Lecturer or Authorised Clinician.
It is the duty of the student to ensure that all entries made in this book are endorsed immediately after the teaching session by the Supervising Lecturer or Authorised Clinician. Retrospective entries are NOT entertained. Endorsements by House Officers are NOT permissible.

Notes on using log book-2

Activities of every week should be appropriately recorded and endorsed. Activities work of one week cannot be used to compensate for losses in previous weeks. Students will be expected to do AT LEAST TWO night duties and ONE weekend duty per rotation. (to get acquainted with what happens at night) As a self-monitoring tool, it is expected that the logbook will enable the Medical Student make a personal assessment of his/her own attendance of teaching sessions, progress in the acquisition of skills and knowledge on a regular basis during clerkship.

Log book Content-1

Contents
INTRODUCTION............................................................................................................................... 3 JUNIOR CLERKSHIP ....................................................................................................................... 5 WARD ROTATIONS ....................................................................................................................... 5 JUNIOR CLERKSHIP WARD ATTENDANCE ............................................................................ 6 A: INDIVIDUAL WORK: Cases Clerked ............................................................................ 7 B: BEDSIDE TEACHING -1 .................................................................................................. 17 C: GROUP TUTORIAL -1 ...................................................................................................... 21 D: OUT-PATIENTS CLINIC -1 ............................................................................................. 23 CERTIFIED ACTIVITY SCORE - JUNIOR CLERKSHIP ..................................................... 25 SENIOR CLERKSHIP ..................................................................................................................... 26 WARD ROTATIONS ..................................................................................................................... 26 SENIOR CLERKSHIP WARD ATTENDANCE .......................................................................... 27 A: INDIVIDUAL WORK: Cases Clerked ......................................................................... 28 B: BEDSIDE TEACHING -1 .................................................................................................. 38 C: GROUP TUTORIAL -1 ...................................................................................................... 41 D: OUT-PATIENTS CLINIC -1 ............................................................................................ 43 LIST OF PROCEDURES ................................................................................................................ 45 SPECIAL CLINICS.......................................................................................................................... 52 CERTIFIED ACTIVITY SCORE - SENIOR CLERKSHIP ..................................................... 54

Log book Content-2

ROTATION Date Started Date Completed Date & Signature Of Unit Head

B4

B5

UNITS

C5

MBU

PEU

Log book Content-3

INDIVIDUAL WORK: Cases Clerked
WEEK 1:
Ward
Date beginning: Supervising Lecturer/Unit Head: ..

Patients Name, Age, Sex

Diagnoses

Discussed with

Lecturers /Authorised Clinicians Signature and date

Night/Weekend duties:

Date
1. 2. 3.

Ward

Time In

Time out

Supervising Doctors Signature

Log book Content-4

Bedside Teaching
Date Ward Topic Specialist/Authorised Clinician Clinicians signature

Log book Content-5

GROUP TUTORIAL
Date Topic Specialist/Authorise d Clinician Clinicians signature

Log book Content-6

OUT-PATIENT CLINICS
Date Venue/Clinic Specialist/Authorised Clinicians sign.

Log book Content-7

LIST OF PROCEDURES
DESCRIPTION DATE OBSERVED PERFORMED SUPERVISING CLINICIANS NAME & SIGNATURE.

Intravenous line setting

Blood letting

Log book Content-8

SPECIAL PROCEDURES
Clinic
1

Date

Specialist/Consultant

Asthma

Cleft Lip & Palate Clinic

Paediatric Chest Clinic

Paediatric HIV Clinic

UNIT

C5

B5

B4

Case Clerked & Discussed

Night Duties Days of Ward Rounds/Bedside Teaching Group Tutorials attended Out-patients Clinics attended IV Line setting/Blood letting Performed Lumbar Punctures Performed CPR observed

ROTATION

Log book Content-9

CERTIFIED ACTIVITY SCORE Junior and Senior Clerkships

MBU

PEU

Certified Activity Score

Core Procedures
Special Clinics Attended Total Signature of Unit Head & Date

General Issues -Student Conduct

Attendance issues!!! [14-day rule.Students Guide: Registration] Punctuality Dressing Student-patient relationships

Relationships with (co-) health workers Clinical tools hammers, etc. Equipment Use of Hospital Consumables e.g. Stationery Paedics Library

Respect for patients & privacy

EXCERPT FROM PTS CHARTER

A. Respect for the patient as an individual with a right of choice in the decision of his/her health care plans. B. The Right to protection from discrimination based on culture, ethnicity, language, religion, gender, age and type of illness or disability.

EXCERPT FROM PTS CHARTER 2

1. The patient has the RIGHT to KNOW the identity of all his/her caregivers and other persons who may handle him/her INCLUDING STUDENTS, trainees and ancillary workers.

NAME TAGS!!!

PATIENT,S CHARTER 3
The patient has the right to privacy during consultation, examination and treatment. In cases where it is necessary to use the patient or his/her case notes for teaching and conferences, the consent of the patient must be sought.

PATIENTS CHARTER 4

The patient is entitled to confidentiality of information obtained about him or her and such information shall not be disclosed to a third party without his/her consent or the person entitled to act on his/her behalf except where such information is required by law or is in the public interest.

SELF- TEACHING!!!
PROVERBS 2:2-5. Turn your ear to wisdom APPLY your heart to understanding..CALL OUT for insight.LOOK FOR IT as for silver..SEARCH FOR IT AS FOR HIDDEN TREASURE

THERE IS A GOLD MINE OF INFORMATION ON THE WARDS DIG FOR IT!

for the Grasshopper

Pro 6:10-11 A little sleep, a little slumber, a little folding of hands to sleep so shall your poverty (of medical knowledge) come on you like a prowler, and your need like an armed man

Standard Recommended Textbooks

Current Diagnosis and Treatment in Pediatrics - by William W. Hay, Myron J. Levin , Judith M. Sondheimer, Robin R Deterding Illustrated Textbook of Paediatrics: With STUDENT CONSULT Online Access Tom Lissauer MB BChir FRCP FRCPCH , Graham Clayden MD FRCP FRCPCH

Nelson Essentials of Pediatrics, 5E with STUDENT CONSULT by Robert Kliegman, Robert Kliegman
Textbook of Paediatrics DB Jelliffe and Stanfield Stanfield

Child Health in the Tropics -

Reference:
Nelsons Textbook of Paediatrics Paediatrics - Fofar