Overview
The NICU rotation is a preceptorial rotation lasting 0.5 blocks. The rotation occurs in the Neonatal Intensive Care Unit and Newborn Nursery of Memorial Hospital. The teaching of neonatology in the program includes this rotation as well as experiences in the Family Medicine Center, the noon conference series, the periodic “NICU Grand Rounds” and on other rotations (ee other curricula).
Goals
- At the completion of this rotation, the resident will have an understanding of the practice of neonatology in the NICU of a community hospital setting which will facilitate appropriate referral practices in the future.
- At the completion of this rotation, the resident will have gained knowledge and skills in the areas of neonatology pertinent to the practice of family medicine.
Objectives
At the completion of this rotation, the resident will have demonstrated to the satisfaction of the NICU preceptor:
- medical knowledge in neonatology pertinent to the practice of family medicine, including the appropriate evaluation and treatment of (MK): the unstable/premature infant, congenital malformations, common genetic syndromes, infants requiring fluid and nutritional management, neonatal infection, respiratory disorders of the newborn, seizures in the newborn, congenital heart disease, and hyperbilirubinemia.
- the ability to perform an appropriate history and physical examination on the NICU patient and to present these findings to another physician in an appropriate manner (PC).
- the ability to interpret appropriate data related to the NICU patient and arrive at reasonable diagnostic and management decisions, weighing alternatives, benefits and risks of diagnostic and therapeutic options, and co-managing patients appropriately with other specialists (PC).
- the ability to make appropriate decisions to assure high-quality care in a cost-effective manner (SBP).
- communication and interpersonal skills which facilitate positive and therapeutic relationships (ICS).
- the ability to work cooperatively with other health professionals as part of a healthcare team (PC).
- compassion, respect and integrity; responsiveness to the needs of patients and society that supersedes self-interest; accountability to patients, society and the profession; a commitment to excellence and ongoing professional development (P).
- a commitment to ethical principles pertaining to the provision or withholding of clinical care, confidentiality of patient information, informed consent and business practices (P).
- sensitivity and responsiveness to a patient’s culture, age, gender and disabilities (P).
There are no specific procedural requirements for this rotation. However, there is a separate Procedures Curriculum, and residents may gain experience meeting these requirements during this rotation. Procedures typically performed by residents on this rotation with the neonatologist include (PC): examination of the newborn, phototherapy, umbilical catheterization, and neonatal resuscitation.
Implementation
This is a preceptorial rotation, so the resident is assigned to the NICU group at Memorial Hospital. The resident will accompany the neonatologist during his/her professional activities in Memorial Hospital. In the course of seeing patients, the neonatologist will provide experiential learning, role-modeling and one-on-one teaching to the resident. At the discretion of the preceptor, the resident may be assigned to research specific topics in neonatology.
The resident is responsible for contacting the neonatologist prior to the start of the rotation to arrange a schedule for the rotation. The resident must continue to meet usual residency obligations to his/her Family Medicine Center population including attending scheduled clinics, caring for continuity patients admitted to Memorial Hospital and rounding in the nursing home. The resident is expected to attend noon conferences and abide by duty-hour restrictions in keeping with usual program policies. Upon completion of the rotation, the resident must complete and return the evaluation form provided by the program.
All residents will become NRP certified during residency but the training may be scheduled outside of the scope of this rotation block.
Evaluation
The NICU preceptor will complete an evaluation form at the end of the rotation. Residents will specifically be evaluated on the following ACGME Milestones:
- PC-1: Cares for acutely ill or injured patients in urgent/emergent situations and in all settings.
- MK-1: Demonstrates medical knowledge of sufficient breadth and depth to practice family medicine.
- PROF-2: Demonstrates professional conduct and accountability.
- C-2: Communicates effectively with patients, families and the public.
- C-3: Develops relationships and effectively communicates with physicians, other health professionals and healthcare teams.
