SOM Elective Brochure

Electives Type:  Clinical

Elective Title
Acting Internship in Pediatrics-Pediatric Intensive Care Unit at Dell Children's Medical Center of Central Texas in Austin
Course Number
Prerequisites: Successful completion of Year 2 
      Additional Requirements:
Successful completion of Pediatric Clerkship Rotation
Responsible Faculty Director:
Alexandra Wilson, MD
Other Faculty:
Location to Report on First Day
Judy Terlik at or 512-324-7860
Periods Offered
including Period 12 (June), including the holiday vacation Period 13 (Dec)
Maximum Enrollment

 The student will, through participation as an acting intern, develop skills in the assessment, stabilization, diagnosis and management of critically ill infants and children.

 Under the supervision of a pediatric intensivist the acting intern should accomplish the following objectives. 1. The student will be able to perform a physical examination on a critically ill infant or child and identify problems quickly and accurately. 2. The student will, under the supervision of an intensivist, devise an appropriate management plan for a critically ill infant or child. 3. The student will, under the supervision of an intensivist, develop the ability to perform the following procedures: Start a peripheral IV, Lumbar puncture, Endotracheal intubation, Venous puncture, Arterial puncture, Urethral catheterization, Nasogastric tube placement, Bag-valve mask airway management. The student will keep a log of procedures and present it to Dr. Wilson at the end of the rotation. 4. The student will take patients in rotation with the other residents and is responsible for the patientsí hospital stay, including the admission physical examination and orders, daily notes, transfer and discharge summary. 5. The student will, under supervision of the intensivists, learn basic mechanical ventilator management and administration of routine respiratory medications.

Description of course activities
 Please refer to the "Objectives" section.

Type of students who would benefit from the course
 To enroll, UTMB students should submit a C-form to Judy Terlik at for approval. Visiting students should submit an application through VSAS: Select UTMB at Galveston as the host institution and indicate you wish to take PEDU 4037 on the application.

Weekly Schedule
  Clinical Activities (please insert estimated schedule here)
  Day of Week AM PM
  Monday 7:00 7:00
  Tuesday 7:00 7:00
  Wednesday 7:00 7:00
  Thursday 7:00 7:00
  Friday 7:00 7:00
  Average number of patients seen per week: 10-18  
  Call Schedule:   Two Friday night calls, two Saturday 24-hour calls (day/night)  

  Research Activities (please insert estimated schedule here)
  Activity Hours per Week
  Faculty contact time

  Self-directed study

  Data collection/analysis


Method of student evaluation
Check all that apply - complete appropriate section(s) only:
1.  Clinical Observation
  A. Where are students observed on this elective?
    Inpatient service   Ambulatory   Surgery   Standardized patients
Patients simulators   Other
  B. Frequency - How often are students observed clinically?
  C. Format - What method(s) are used to document the student's clinical performance?
    Daily oral feedback   End of period oral feedback   Written feedback

2.  Oral Presentation
  A. Audience - To whom does the student present?
    Faculty and residents
  B. Frequency / duration of presentation(s)?
  C. Format - What guidelines are set for the student's presentation?
    Clinical presentation format - See resident guide to the PICU for format.
  D. Assessment - Who assesses the student's presentation performance?
    Self-assessment   Peer assessment   Faculty assessment
  E. Method of content selection
    Current cases  Student-selected topic   Assigned topic

3.  Written Assignment (H&P's, notes, papers, abstracts, etc.)
  A. Frequency of written assignment(s)?
    Daily H&P
  B. Format - What guidelines are set for the student's written work?
    Clinical SOAP format
  C. Length of written assignment(s)?
    Abstract   Annotated bibliography   1 - 2 page paper   3+ page paper
  D. Are recent references required?   No    If yes, how are they selected?
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
  F. Audience - Who assesses the studentís written performance?
    Peer Assessment     Faculty Assessment     Other

4.  Examination
    Oral   Written multiple choice   Written essay / short answer   OSCE

5.  Extra Course Activities
  What expectations do you have for the student to demonstrate participation in the elective (e.g. small group activities, seminars, thoughtful questions, providing resources, journal club, resident lecture attendance)?

6.  Other Modes of Evaluation
  Please explain below.
    The student will be evaluated by the attending pediatric intensivist on the following criteria: 1. Attitude 2. Willingness to work and seek knowledge 3. Responsibility 4. Working relationships with personnel, patients and other physicians 5. Thoroughness 6. Dedication to learning and ability to apply knowledge 7. Achievement of stated performance objectives of the rotation.
7.  If this course is an Acting Internship, please complete the following:
  A. Specify how the student will be given formative feedback on their clinical skills.
    Students will receive daily feedback from the PICU attendings on their written and oral presentations.
B. List advanced clinical skills that a student will be assured an opportunity to practice.
    Students will be responsible for the evaluation and care of highly complex pediatric ICU patients. They will be expected to manage three patients at a time. They are primarily responsible for their patients but will have a senior provider assigned to each patient as well to provide assistance.
C. List other advanced clinical skills that a student may be exposed to depending on clinical case availability.
    Airway management, placement of central venous catheters, lumbar punctures.
  D. How will the acting intern student have responsibilities similar to a PGY1 resident? How will their responsibilities differ?
    The PICU only has PGY2/PGY3 residents. The students will act at a PGY1 level with assistance from senior providers. The only exception is that with our current order entry system, medical students cannot write orders to be co-signed. We are hopeful this will be rectified in the future.
  E. How will this course help prepare a student enter an internship in this field or a related field?
    This is a rigorous course that will help students implement the knowledge they have acquired in clinical pathophysiology. They will learn how to identify and manage ill pediatric patients. They will learn how to navigate a busy unit and will acquire good time management skills.
  F. How will midpoint feedback be provided to the student? How will you remediate deficiencies identified at midpoint?
    Students will meet with the course director mid way through the rotation. At that time they will receive feedback from the attendings the student worked with during their first two weeks. We feel that it is important for students to be responsible for their own learning therefore student will be given the directors contact information and will be expected to arrange the meeting. In addition students will discuss with the director their goals for the rotation before they begin.
  G. Acting Internship students often seek letters of recommendation following their experience. How many different faculty are they likely to encounter during this course? What is the usual number of working days they can expect to encounter the same individual faculty member? Describe the degree of supervision and interaction with faculty vs. residents or other providers.
    Students will work closely with four to five PICU attendings. They are expected to cover nights and day shifts following the same schedule as the residents. Each PICU team is composed of an attending physician, one resident, one NP/PA. There is therefore ample opportunity for a close working relationship with the attending.