PEDIATRICS CLERKSHIP

Code

11146

Academic unit

NOVA Medical School|Faculdade de Ciências Médicas

Department

MMIA

Credits

7

Teacher in charge

Prof. Doutor Luis Varandas

Teaching language

Portuguese

Objectives

Pediatric Medicine, the scope of which is described below, has as main objective the understanding of Pediatrics as the medicine of a whole age group, from conception to teenage years. Accordingly, general learning objectives are established in terms of knowledge, attitudes (presence) and skills (demonstrated: know-how, or evoked: knowing how to).

To acquire skills, it is therefore necessary to consider a logical sequence of key steps:

theory (knowledge), observation (observing how it’s done in order to explain how to do it), practice with support (starting to do things with the help of an experienced senior and gaining experience), practice by routine (performing techniques or procedures autonomously).

According to the orientations provided in the curriculum of the Faculdade de Ciências Médicas, in the 6th year and considering the Bologna objectives, aspects of differential diagnosis and therapy should be emphasized. Thus, regardless of their future career choices (as a general practitioner, pediatrician or specialist) at the end of the course and after a period of tutored clinical practice, the student should have basic knowledge, skills and acquire sensitivity to the improvement of attitudes. The student should also acquire sufficient autonomy for the practice of pediatrics and research ability, encouraging research.

Prerequisites

 

Subject matter

- The main pathological issues in childhood and adolescence in Portugal and the world, through the
integration in clinical practice (inpatient and outpatient care);
- The organization of different healthcare structures in our country and their relationship;
- The principles and practices of preventive pediatrics and health education and promotion in
childcare;
- Prenatal assistance and preventive measures in the prenatal period;
- Psychosocial factors influencing family, school and community, susceptible of impacting child’s
health;
- Child and family’s reaction to disease and its comprehension;
- Normal and impaired growth and development and integration in a family and social
environment;
- Genetics, nutrition and immunity;
- Diagnosis and general management of common pediatric illnesses, including urgent and emergent
situations;
- Early identification of growth and developmental deviations;
- Early identification of increased risk situations and/or signs of suspicion of rare disorders;
- Early identification of clinical situations requiring referral to specialized services, with a focus on
multidisciplinary approach;
Skills
- History taking;
- Physical examination, respecting the child or adolescent’s personality and informing the parents;
- Communicating with the child or adolescent, family and other healthcare workers
- evaluating growth, development and nutritional status;
- Interpreting standard diagnostic tests, diagnostic discussion and therapeutic interventions;
- Prescribing common drugs;
- Performing simple techniques and procedures (airway suctioning, bag and mask ventilation,
nasogastric tube positioning, capillary blood glucose determination, urine testing with reagent test
strips);
- Evaluating general status, level of consciousness, meningeal signs, signs of respiratory distress,
shock, asthma and cardiac failure;
- Recognizing severity criteria;
- Understanding near-normal situations;
- Effectively and humanely communicate information regarding diagnosis, prognosis, diagnostic
plan, and treatment to the patient and family (including written report).
Attitudes
- Understanding the importance of primary care in promoting the physical, mental and social wellbeing
of the child and adolescent;
- Understanding the importance of family in the health of the child and adolescent;
- Understanding the repercussion of disease, disability and death of a child in the family;
- Understanding the need to take care of the child while fighting the disease;
- Understanding the need for continuing pediatric care;
- Understanding and approaching psychosocial issues in abused children and adolescents;
- Accepting the general principles and the ethical and moral responsibilities inherent to child and
adolescent care;
- Accepting the ethical duty of continued education pursuing skill improvement and avoiding a
passive attitude;
- Accepting a multidisciplinary care approach;
- Taking part in research projects adequate to the differentiation level and willingness of the
student;
- Improving perception of administrative and financial aspects concerning medical activity;
- Understanding the importance of hand washing as a means of preventing infections (before and
after observing each child);
- Understanding the importance of proper behavior in hospitals or other healthcare facilities by
avoiding, for example, inadequate clothing, loud voice, comments in the presence of the child or
family and interfering with patient care;
- Respecting cultural and lifestyle differences of patients / families and colleagues;
- Recognizing children’s rights, hospitalized or not, respecting confidentiality and taking into
account the possible need of informed consent;
- Accepting the uncertainties of Medicine;
- Understanding the ethical and moral responsibilities of medical care;
- Understanding the importance of providing high quality medical care;
- Developing self-criticism and accepting peer evaluation of performed tasks;
- Accepting personal limitations and understanding the importance and philosophy of teamwork,
asking for peer support whenever needed;
- Developing the ability to adapt to change;
- Taking responsibility, whenever possible, in the advance in medical knowledge aiming to
improve healthcare;

Bibliography

LISSAEUR, Tom; CLAYDEN, Graham. Illustrated Textbook of Paediatrics. 4rd ed. Oxford: Mosby Elsevier, 2012.

AMARAL João Videira. Tratado de Clínica Pediátrica. 1ª ed. Lisboa: Abbott Laboratórios, 2008.

PALMINHA, J. Martins; CARRILHO, Eugénia Monteiro. Orientação diagnóstica em pediatria: dos sinais e sintomas ao diagnóstico diferencia. Lisboa: Lidel, 2002.

 

MARCDANTE Karen; KLIEGMAN, Robert; BEHRMAN, Richard; JENSON, Hal. Nelson Essentials of Pediatrics, 6th ed. Philadelphia, Elsevier Saunders, 2011.

 

KLIEGMAN, M. Robert; STANTON, Bonita; GEME, St Joseph; SCHOR, F. Nina. Nelson Textbook of Pediatrics. 19 th ed. Philadelphia, Elsevier Saunders, 2011.

Saúde Infantil e Juvenil: Programa-tipo de actuação. Direcção Geral da Saúde, Orientações Técnicas nº 12. 2ªed. Lisboa, 2005.

Urgências no Ambulatório em Idade Pediátrica. Direcção Geral da Saúde, Orientações Técnicas nº 14, vol. I. Lisboa, 2004.

Urgências no Ambulatório em Idade Pediátrica. Direcção Geral da Saúde, Orientações Técnicas nº 14, vol. II. Lisboa, 2005.

Teaching method

The teaching-learning process of the pediatrics rotation includes: four week blocks comprising 196 hours (120 contact hours; 5,5 hours daily). Schedule arrangements should be made on an individual basis with each tutor.

Evaluation method

Final evaluation is expressed on a scale of 0 to 20 and is obtained taking into account the continued evaluation and seminar presentation. The former will be attributed by the tutor and the latter is the average resulting from the evaluation given by the tutors and chair of Pediatrics after Seminar presentation. Final grade will be rounded to the unit. Students not taking part in the seminar will be graded "0" in this segment. Students with final grade of 10 or higher will be approved.

Courses

• Integrated Master Degree in Medicine