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Innovations in Education for Pediatric Residents

Resuscitation Skills

residents performing a mock resuscitation

Residents receive exposure to resuscitation skills and attain leadership skills that prepare them for emergency patient care situations. These include:

  • Monthly simulation center resuscitation training on high-fidelity manikins
  • Monthly unannounced “mock codes”
  • NRP during orientation
  • PALS during orientation
  • Participation in Rapid Response Team

Procedures

Residents participate in scheduled times within the Simulation Center to practice procedures such as venipuncture, lumbar puncture and bladder catheterization on high-fidelity manikins. Other opportunities include guided mentorship during the pediatric emergency department time at Johns Hopkins PED and also additional opportunities at St. Agnes community hospital.

Teaching Residents to be Teachers

  • An annual 1/2 day Teaching Retreat is held in June of each year for the upcoming PL-3 residents. The retreat is designed by the Chief Residents and Pediatric Program and Associate Program Director.
  • PL-3 residents who participate in the Harriet Lane Clinic acute care rotation are observed by a faculty member for their teaching and feedback given.
  • PL-2 residents who serve as supervisory residents at St. Agnes participate in an educational curriculum to enhance their ability to precept.
  • Inpatient ward attendings observe rounds led by the PL-3 residents on the general ward services and provide feedback concerning their leadership and teaching skills.

Death and Bereavement Seminar

This important activity has been a part of residency training at Johns Hopkins since 1995. The annual Cameron Kravitt Foundation Death and Bereavement Seminar is a one-day seminar for PL-2 residents. Residents work with standardized patients in scenarios involving sharing bad news. The day also includes discussion about autopsy, organ donation, spirituality, a parent panel and self-care.

Structured Clinical Observations (SCOs)

These take place during the acute care rotation in the PL-1 year. An experienced faculty member observes a patient encounter and then gives guided feedback using evidence-based checklist. SCOs also are performed twice a year during the resident continuity experiences.

Mental Health Rotation

This two-week rotation has been designed as a collaborative effort between our general pediatric faculty and child psychiatry staff. PL-2 or PL-3 residents gain exposure to mental health issues working in mental health sites and then extrapolate to general pediatric settings.

Advocacy

Residents have many opportunities for advocacy, starting with the advocacy they do for individual patients. The community advocacy rotation allows residents to select from an array of opportunities, including work on a Care-a-Van that provides primary care for underserved communities, working with a pediatrician at a federally qualified clinic serving indigent patients, work with the Baltimore City Health Department, or participation in clinics for children with special health care needs.

Adolescent Interviewing

PL-2 residents participate in a longitudinal experience in interviewing adolescents concerning high-risk behaviors including substance abuse. An adolescent faculty member with expertise in this area leads the intervention, which includes experiential and didactic sessions.

Morning Report

PL-3 residents who serve as supervisors on the general inpatient ward teams and all available PL-3 residents attend morning report three mornings each week. Shared learning takes place between the residents and faculty. Residents present patients and there is discussion about the differential diagnosis, appropriate treatment options and available evidence to support patient care decisions. Our departmental librarian is in attendance to provide support for literature searches. Focus is directed at the PL-3 level to enable more targeted education and sophisticated discussions to enhance their leadership skills. Morning report also serves as an opportunity for shared communication among PL-3s, the chief residents and faculty-level program leadership.

Internet Learning Center (ILC)

An Internet-based continuity clinic curriculum has been developed by Hopkins faculty and utilized by our pediatric residents. This curriculum is now being used by over 40 other pediatric programs throughout the country. The pre- and posttest allows residents to track their progress and the modules are evidence based with links to pertinent articles and guidelines.

Harriet Lane Handbook

The internationally recognized Harriet Lane Handbook, thought by many to be the ultimate pediatric resource for patient care, is published every three years. The chief residents serve as the editors and the senior residents from that particular year author chapters in conjunction with faculty selected for their expertise.

Chief Residents

Future chief residents are selected during the fall of their PL-2 Year. They prepare throughout the remaining years of residency for that responsibility, participating in long-term departmental projects and taking on various leadership roles. Following completion of residency the future chiefs leave the program for a year. During that year they may begin a fellowship (to return to the fellowship after their chief year is completed), work as a pediatric hospitalist, earn a graduate degree or work internationally. They return to the program following that year with additional experience and knowledge, prepared to serve as leaders and educators.

Speed Mentoring

Speed mentoring is a series of short, focused conversations. Residents meet with 5-6 faculty from a variety of subspecialties for 10-minute conversations. This allows for one-on-one conversations where residents can better understand faculty goals/values and various components of faculties’ careers. This is a new venue to foster increased networking and mentoring of our residents and can also serve as a gateway for longitudinal mentorship. Residents are provided with faculty CVs for examples of an academic CV. Speed mentoring occurs 1-2 times every academic year.

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