Learning

Residents are required to complete PREP self-assessment questions annually (about 250 questions). PREP is a program developed by the AAP and available online to the residents to assist in preparation for the American Board of Pediatrics Certifying Examination. In addition, by requiring completion of these questions, the program hopes to instill lifelong habits of learning.

All residents are also required to take the yearly American Board of Pediatrics In-Training Examination to help prepare for the American Board of Pediatrics Certification Examination.

 

The Community Advocacy through Resident Education (CARE) curriculum is part of a collaborative program called MoCARE which includes the four pediatric residency training programs in the state of Missouri. The goal of MoCARE is to strengthen community pediatrics education for residents and to improve outcomes for Missouri's children through more effective advocacy.

Curriculum

The CARE curriculum is designed with flexibility to allow residents to focus on areas of community pediatrics that spark their interest and passion, fostering sustainable advocacy efforts that will persist even after residents complete their pediatric training. Unlike a conventional residency rotation, the CARE curriculum involves activities such as site visits, lectures and projects that span the entire pediatric residency experience.

During their intern year, residents will gain awareness of community pediatrics through community partner site visits and participation in assigned educational activities during their CARE rotation. These visits will sometimes involve shadowing at a community site, discussing a topic with a community leader or performing a specific community-related task such as a nutrition assessment or educational initiative with a community organization. The site visits and activities are diverse, with each intern engaging with 20 or more partners such as schools, shelters and food pantries throughout their intern year. As a result, residents will begin to understand how these practices can be utilized in your various pediatric practice settings.

Following their intern year, residents will have the opportunity to choose a scholarly project that implements principles of advocacy and community pediatrics. This project can include collaboration with other residents, faculty and community agencies that relate to the project that residents have chosen. At the conclusion of their project, residents will submit a poster presentation that will meet the pediatric residency program scholarly project requirement.

Additionally, at the end of their intern year, residents will be given the opportunity to apply for the MoCARE advocacy track. Two residents will be chosen from each year group to spend their second and third years of residency emphasizing topics in pediatric advocacy and community health. These two rising PGY2 residents will join the six PGY2 advocacy track residents from the three other pediatric residency programs in Missouri at a leadership conference in Columbia, Missouri specifically targeted to leadership and advocacy skills in pediatrics. Additionally, they will spend several elective rotations through the remainder of their residency engaging in both clinical and scholarly endeavors related to improving the health of children throughout the region.

The Ann Manganaro Global Health Pathway in Pediatrics (GHPP) is an opportunity for residents with an interest in pursuing a career that includes global health to gain additional education in international children’s health within the ACGME requirements during their last two years of residency.

During their first year, pediatric interns interested in pursuing this pathway will have the opportunity to apply for review by the GHPP selection committee. Up to two residents each year will be chosen from the applicants to begin the pathway in their second year.

The pathway requires residents to include within their curriculum elective months including infectious diseases, gastroenterology and hematology/oncology. During their second year, they will complete an elective month consisting of a two-week learning experience in an underserved international location, and a two-week global health course held in conjunction with Washington University Medical School. 

During their third year, they will participate in a Medicine Abroad Program (MAP) that includes a retreat focusing on global health issues and a one-month learning experience in a low-resource location abroad.

Participants will be required to do additional learning outside of the above electives, and to give a presentation to the medical staff regarding their global health experiences. Upon completion of the GHPP at the end of their third year, participants should have a greater understanding of international child health issues, preparing them for future opportunities in global health.

Grand Rounds

Our Grand Rounds are held Wednesday mornings from 8-9 a.m., September through June. Topics vary, from the state of the hospital to case conferences to speakers brought in from other institutions around the country, and much more. Residents’ time is protected to attend Grand Rounds.

Academic Half Days

Interns and senior residents attend these conferences every other Thursday on a rotating schedule. The conference runs from 1-5 p.m. with time completely protected from clinical duties. Each academic half day is made up of a series of interactive learning opportunities ranging from simulation experiences to didactic series to self-directed case exploration. The academic half days are chaperoned by subspecialty and general academic faculty and address important topics necessary for the education of a general pediatrician and to prepare the residents for the American Board of Pediatrics certifying examination. The residents are expected to attend all of these conferences as duty hours and vacation permits.

Noon Learning Experience 

Every day at noon, the program provides lunch with learning. This time is carved out for experiences designed to encourage critical thinking about topics of importance in providing pediatric patient care. This time is used for housestaff meetings and resident social luncheons as well.

Intake Conference

Intake conference involves patient-case presentations from residents who are currently on the inpatient and outpatient wards. Faculty members also attend this conference, both from subspecialty services and from general medicine. These case conferences focus more on differential diagnosis and discussion.

Patient Safety Conference

This conference is held once a month in place of a noon conference, led by one or two of the third-year residents and a faculty mentor. The conference often focuses on one particular case in which patient safety was at risk or where the harm occurred. This conference focuses on systematic changes that can be made to improve patient outcomes.

Chairman's Conference

Led by the chairman of the Department of Pediatrics, these conferences involve residents and faculty discussing interesting inpatient cases with the interns and senior residents involved in the patient's care. Chairman’s conference occurs at noon once a month.

Subspecialty Conferences

All services also have their own conferences. Residents attend and participate when they are on the subspecialty service, when one of their patients is discussed by the division, or simply when they have an interest and are available to attend.

All residents will complete a scholarly project that results in a poster presentation at a minimum. Our residents have routinely presented at the Pediatric Academic Societies (PAS) Meeting, the Pediatric Hospitalist Meeting (PHM), national and regional specialty meetings and local meetings such as the Saint Louis University Primary Care Research Symposium, Saint Louis University Pediatric Science Days, Saint Louis University Graduate Medical Education Resident Research Symposium.

The scholarly projects are based on Boyer’s model of scholarship. His description of scholarship includes the following four categories:

• The scholarship of discovery, which is consistent with traditional research.
• The scholarship of integration, which makes connections across disciplines and places specialties in a larger context.
• The scholarship of application, which demonstrates the vital interaction between research and practice, wherein the one continuously informs the other.
• The scholarship of teaching (educational scholarship), which emphasizes the creation of new knowledge about teaching and learning in the presence of learners.

Research (Scholarship of Discovery)

The faculty at Saint Louis University and SSM Health Cardinal Glennon Children's Hospital are at the forefront of basic science and clinical research. They enjoy mentoring residents through the residency research project. Select faculty will help guide the residents through Institutional Review Board (IRB) certification, mentor selection, background/reference review, project implementation and final presentation. Several times during the project, the resident meets with an expert from the Saint Louis University School of Public Health to optimize their research focus, develop a sound strategy for data collection, and then finally for data analysis, statistical representation and presentation to the department.

Quality Improvement (Scholarship of Application)

All residents will complete the Patient Safety/Quality Improvement curriculum during their ambulatory month in the second year. For those who are interested in making QI the focus of their scholarly work, especially those considering a career in primary care, faculty will mentor you as in the research project (above). You may have the opportunity to join a national QI project with the faculty, or you may select your project based on needs that you identify through the second-year curriculum. Most residents will seek IRB exemption status or expedited approval for their project.

Advocacy and Global Health (Scholarship of Integration)

The scholarly projects for Global Health and Advocacy tracks will be developed and mentored with the faculty who oversee these two tracks.

Education (Scholarship of Teaching)

There are many opportunities for working with faculty on educational interventions. Sometimes, these projects are with national organizations, allowing for broad collaboration across residency programs. If you are planning a career in academic pediatrics, an educational project may be right for you.

Faculty And Resident Publications, Abstracts, Presentations and Grants

In the past five years, pediatric residents/fellows and faculty have had over 300 publications including chapters in books, abstracts and articles in critically acclaimed journals. These publications cover all areas of clinical medicine and basic science relating to pediatrics and related areas of medicine.

During the present academic year, numerous funding agencies and local and national organizations supported the research activities of members of the Department of Pediatrics. Active grants for the Department of Pediatrics total more than $7 million at present. Major sources of funds included the National Institutes of Health, the Cystic Fibrosis Foundation, the American Heart Association, the American Diabetes Association, Alpha-1 Antitrypsin society, and private industry. Additionally, the SSM Health Cardinal Glennon Children’s Hospital administration will provide small “Fleur-de-Lis” grants for starting research projects.

Residents are welcome to share in all three major components of the mission of the Department of Pediatrics: Patient Care, Research, and Teaching. Residents have an important role in teaching medical students, fellow resident trainees, nursing staff, and families. We recognize that there is usually little formal training that residents get in medical school regarding education. So, we provide training directed at how to teach.

Throughout the PL2 year, residents participate in the Stanford Teaching Curriculum taught by core faculty. Topics range from creating a safe learning environment to providing formative feedback about medical knowledge. Participation in this curriculum has led to the residents having the highest ratings from medical students compared to all other clinical rotations.

It is the strong opinion of the program directors and chairman that only through continuous mutual input from residents and faculty will Saint Louis University's residency maintain its state-of-the-art pediatric educational experience. Evaluations are taken very seriously, and every effort is made to instill improvements to the program that are deemed necessary based on these evaluations. Evaluations occur through many different means in this program, as listed below.

Resident Evaluations 

Evaluations are performed using the milestones format. Attending physicians use set guidelines to provide monthly written evaluations for each rotation, as well as a semi-annual evaluation for the continuity clinic. All evaluations are reviewed by the program directors as soon as they are received. Any problematic evaluations require discussion with the appropriate attending(s) and residents, and the resident's preceptor also receives notification.

Semi-Annual Evaluations

The program directors meet with all residents twice a year to review their overall progress in the program. If a resident is having issues or has received a poor evaluation, meetings between that resident and their preceptor or one of the program directors will occur more frequently to allow for remediation, if deemed necessary, and timely completion of training.

Program Evaluation

House staff are expected to contribute to the assessment of the program and faculty. This occurs in a number of ways.

• The Program Evaluation and Improvement Committee (PEIC): The committee includes the program directors, multiple additional attending physicians, the chief residents, and four residents from each class (who are selected by their peers). The committee meets monthly to discuss ongoing issues in the program, and residents from each class are expected to report back to their peers following the meetings.
  
  Residents are required to provide monthly evaluations of each attending physician that they work with, which is done through the website New Innovations. These evaluations are entirely anonymous.
• Each year the individual resident classes have a two-day retreat. These are held off campus and only involve that individual resident class. The third-year resident retreat is typically in August, the second-year resident retreat is typically in September, and the intern retreat is typically in October or November. These retreats provide an avenue for unbiased, anonymous discussion on the pros and cons of the program, and possible solutions to any ongoing problems. Summaries of these discussions are presented directly to the chair of the Department of Pediatrics, with the goal to address and improve the problems, if possible.
• The chair also meets annually with each resident class to discuss their thoughts on the program, and these meetings also lead to discussions among the leaders in the department about ways to improve the program.
• Each year in the spring, residents complete an anonymous online survey regarding the program. The results of this survey are compiled and reviewed by the Program Evaluation and Improvement Committee, and discussions are held, if necessary, on how to address problems that have been identified.