Pediatric Neurosurgery Rotation

Educational Objectives (PGY 4-5)

MEDICAL EXPERT:

  • Discuss the embryologic principles and developments which relate specifically to congenital malformations of the nervous system
  • Complete age appropriate neurosurgical consultation including pediatric neurological examination
  • Assess and manage pediatric patients with traumatic brain and spine injuries
  • Assess and manage pediatric patients with hydrocephalus
  • Assess and manage pediatric patients with brain tumours
  • Assess and manage pediatric patients with craniosynostosis
  • Assess and manage pediatric patients with congenital brain malformations
  • Apply knowledge of pediatric physiology relating to neurosurgery
  • Technical skills in the OR including:
    1. Perform CSF diversion surgery on pediatric patients
    2. Perform craniotomies on infants and toddlers
    3. Perform spinal surgery for pediatric patients including cord detethering

COMMUNICATOR:

  • Establish therapeutic relationships with patients and their families in the clinic, emergency room and on the inpatient units.
  • Communicate effectively with patients and families in order to obtain through, focused histories during patient care encounters
  • Present neurosurgical consultations including detailed history, physical exam and findings of investigations to fellows and attending staff.
  • Document neurosurgical consultations including history, physical examination, findings of investigations and outline of the management plan (both written and dictated as appropriate).
  • Document operative reports and progress notes in the medical record
  • Perform/communicate discharge summaries appropriately for patients being discharged from the neurosurgical service
  • Communicate effectively with patient and their families in emotionally charged situations including breaking bad news, discussing prognosis, disclosing adverse events and addressing complaints
  • Obtain consent for pediatric neurosurgical procedures with appropriate supervision

COLLABORATOR:

  • Work/collaborate effectively as a member of the interdisciplinary care team on the pediatric neurosurgery service, fostering a positive team environment
  • Consult other medical and surgical specialities appropriately in the care of the pediatric neurosurgical patients
  • Work with other healthcare providers and paramedical personnel on multiple levels in the management of pediatric neurosurgical patients
  • Demonstrate safe and accurate written and/or verbal handover of patient issues to colleagues
  • Share the workload and duties appropriately with other members of the resident team
  • Listen and respond appropriately to concerns of other health care providers

LEADER:

  • E
  • Manage own time, education and personal life to ensure a balanced lifestyle
  • Effectively utilize and allocate finite resources using an evidence informed approach
  • Triage patients being able to identify pediatric neurosurgical emergencies that require prompt and immediate management
  • Have working knowledge and be able to manage the complete care of patients on the pediatric neurosurgical ward.
  • Bring forward potential patient safety incidents with a goal of enhancing the system of care on the pediatric neurosurgical service
  • Contribute to the goals of continuous quality improvement by participating in morbidity and mortality review

HEALTH ADVOCATE:

  • Counsel patients and their families regarding preventative strategies for head injury and spine trauma
  • Facilitate improvements in the underlying determinants of health in pediatric neurosurgery patients in an integrated fashion during care delivery
  • Facilitate return of patient to community/alternate care environments in collaboration with the multidisciplinary care team and advocate for access to resources
  • Identify and provide community care/resources to support patients during their medical journey

SCHOLAR:

  • Develop and execute scholarly projects in the field of pediatric neurosurgery, basic neuroscience and/or medical education
  • Actively participate in weekly rounds/educational activities
  • Identify and seek out personal learning needs related to cases encountered on the pediatric neurosurgical service
  • Apply principles of critical appraisal to medical information
  • Facilitate patient, student and peer learning
  • Acquire knowledge in research methods and statistics.

PROFESSIONAL:

  • T
  • Understand and apply principles and laws relating to pediatric consent as it applies to neurosurgery
  • Understand and apply regulations around mandatory reporting such as suspicious injury
  • Foster collegial relationships with staff and residents, neuroscience nurses and other allied health professionals
  • Develop through observation and practical experience professional tactics for effective, honest discussion with patients and families with respect to challenging issues including delivery of grave diagnoses and disclosure of medical error.
  • Exhibit appropriate professional behaviors in practice, including honesty, integrity, commitment, compassion, timeliness, respect and altruism
  • Show appropriate respect for opinions of other health care providers
  • Be able to appraise and identify own limits with respect to knowledge and patient care, and when to ask for assistance and consult effectively.
  • Understand and have a working knowledge of ethics in context of neurosurgical care delivery.

Resources:

  • “Principles and Practice of Pediatric Neurosurgery” – Albright, Pollack and Adelson