Pediatrics curriculum for medical students, Discipline Pediatrics I INSMC, Check list of the practical work activities

1. Medical history and communication
   • Reasons of presentation
   • History of actual disease
   • Personal pathological history
   • Personal physiological history
   • History of the development
   • History of nutrition
   • History centered on organs and systems
   • Family history
   • Social aspect

2. Clinical examination
   Differences in performing the clinical examination at children and adults
   • General approach
   • Vital functions

3. Pediatric clinical examinaton
   • General
   • Teguments and ganglia system
   • Head
   • Eyes
   • Years
   • Nose
   • Oral cavity, pharynx
   • Throat
   • Thorax / Lung
   • Cardio-vasculary
   • Abdomen
   • Osteo-muscular systemm
   • Nervous system – usually performed by observing the children
   • Genito-urinary

Recognizing and treating the sick child

• Prioritizing care for a sick child;
• Use of a systematic approach (ABCDE)in assisting a sick child;
• Demonstrate the ability to perform basic management of the airway;
• Perform cardiopulmonary resuscitation – appropiate maneuvers for the age of the patient;
• Realizing the moment when in need and knowing how to obtain help;
• Calculaton of scores for early diagnosis of deterioration of a child’s health;
• Use of early diagnosis scores for identifying deterioration of a child’s health;

Common/serious ways of debut for some illnesses
Identification, in different contexts (primary care, ambulatory), of:

• Key elements of anamnesis,
• Key elements of the clinical examination,
• signs of seriousness,
• differential diagnoses,
• initial investigations,
• initial treatment,
• existence of national clinic guidelines (where applicable)

For the ways of debut, the student must demonstrate the ability to:

• identify the clinical sign of debut
• perform an initial evaluation of the child,
• initiate a basic treatment,
• seek help when necessary.

Writing of medical prescriptions

• Writing recipes based on age, body weight and body surface area of the child,
• Identifying the most common prescribing errors at children,
• Emphasizing differences in drug metabolism at infants, children and adults,
• Identifying the main tools for ensuring safe prescription at children (hospital’s pharmacist, books such as "Takamoto"),
• Identifying appropiate resources for cases of poisoning (ToxApel etc),
• Writing a secure, accurate and legal prescription for a child using Takemoto or local or national guidelines for various medications.

Practical procedures / investigation

• Identifying the main challenges to perform practical procedures at children,
• Describing the techniques of performing the practical procedures at children (e.g. distractions, play therapy, local anesthetics),
• Describing the utility of performing the practical procedures at children,
• Interpreting the laboratory tests used commonly at children,
• Interpreting the gasometer at children,
• Interpreting the thorax X-rays at children;

Describing the principles (not to do practically):

• Of the aseptic techniques to perform practical procedures at children,
• Of the procedures used frequently in infants (e.g. blood sampling from the heel in infants)

Physiological events, growth and development

• Describing psysiological influences on normal growth in childhood,
• Identifying the main physiological changes from birth to adulthood,
• Describing the healthy child’s alimentation and healthy eating behaviour from birth to adulthood,
• Describing normal behaviour from birth to adulthood,
• Describing the main procurement of child development between 0 and 5 years,
• Describing the principles of the immunization scheme of children from Romania,
• Describing the main schemes of prevention from rickets;

Abuse prevention in children

• Listing the risk factors for child abuse,
• Defining the main types of child abuse,
• Describing the symptoms, signs and signs of seriousness of abuse at children,
• Identifying the procedure of lifting suspicion of abuse at children,
• Identifiying the duty of every medical personnel to report any suspicion of abuse at children;

legal and ethical bases of child health

• Explaining the principles of obtaining medical consent at child and youth,
• Describing the principles of confidentiality regarding children and youth– see the bioethics courses for students - http://www.eticamedicala.ro/,
• Explaining the parental responsibility over a child ( and who are the people that can have it),
• Identifying the ethical and legal dilemmas in Pediatrics;

Public health/ global health

• Explaining the concepts of reportable diseases,
• Identifying the national sources of information regarding the reportable diseases,
• Describing the social and environmental determinants for health child in Romania and in the world,
• Listing some of the special needs of health at vulnerable groups in Pediatrics (e.g. children from broken families, with low socio-economical level, refugees);

Good governance, patient safety and good practice

• Explaining the importance of patient safety in relation to child health,
• Describing the opportunities of improving the patient safety in Pediatrics (e.g. learning from critical incidents and accidents prevented at the last moment, projects of improvement of the quality of medical assistance in Pediatrics),
• Describing the importance of lifting suspicion when the safety of the patient may be compromised,
• Demonstrating the willingness to improve continuously the knowledge, reflection and learning (including families),
• Demonstrating the capacity to perform a basic bibliographic research to answer a clinical question in Pediatrics;

Attitude/behaviour

General principles of child health for medical students:

• Children are not a reason to be scared,
• Children are different from adults,
• The health and welfare of children are important to all doctors,
• The multidisciplinary approach is a vital component of pediatric practice.

* child – meand newborn,infant, child or young.

Bibliography for students

• Compedium of Pediatrics 3’rd edition, Georgescu A, Anca IA, 2009
• Nelson’s Textbook of Pediatrics, ed 17, 2015
• Cloherty Manual of Neonatal Care, ed 2012

Optional courses for students

1. Shaking baby syndrome – diagnosis, prophylaxis and treatment, academic staff: Associate Professor. Tatiana CiomAcrtan, Assitant Lecturer Dr. Anca Lădaru
2. Inhalation therapy at children, academic staff: Assistant Lecturer Iustina Stan
3. Pediatric ecography, general notions, academic staff: Assistant Lecturer Dr. Beata Acs, Asistant Lecturer Dr. Mirela Ritivoiu

Subdomains of interest for research activity

• Bronchial asthma,
• cystic fibrosis,
• neonatal sepsis,
• prematurity,
• retinopathy of prematurity,
• celiac disease,
• neonatal screening