Logbooks

Students utilize the electronic logbook to keep track of all patients seen during the clerkship (inpatient and outpatient) with the clinic name (e.g., GI Clinic, ER, Hospital), discipline, diagnoses, whether the experience was observed or a workup performed, and any procedures performed or observed. 

 

If a student does not have exposure to an adequate amount of patients, extra clinic(s) are assigned to gain the appropriate exposure.  The logbook must be complete with all entries done by the afternoon of the board shelf exam to receive a “meets expectations” for this requirement. 

 

The final score for the clerkship is not released until the student’s logbook is completed

 

ED2 Card

The student is provided with a card of all patient types that must be seen prior to completing the clerkship.  An attending physician or a resident will sign for each patient type.  This card is reviewed for progress at the midterm meeting. 

 

Faculty Observed Student Exam (FOSE Card)

The student will be provided with a card listing the specific examinations that must be observed prior to completing the clerkship. Special attention should be paid to pediatric-specific techniques of physical examination. All exam components may not be performed on the same patient.  Doing one exam component at a time (e.g. neuro exam for baby) may be more meaningful to the student, more convenient for the preceptor, and more tolerable for the patient. Examination techniques may be observed during either the inpatient or outpatient portion of the clerkship.  The attending physician observes the student and provides immediate feedback. During the inpatient portion of the clerkship time may be scheduled with the pediatric hospitalist to complete patient physical examinations for the FOSE card.

 

H&Ps

When taking the history and physical, the student must be able to organize the available data so that the likely diagnosis is supported, leading to a rational plan for investigation and treatment. The appraisal of the student will be focused on ability. The ability to function effectively and to cerebrate clearly is what is desired above all. Emphasis is on cogent and logical thought—not on a textbook reiteration of the patient’s problem or differential diagnosis. 

 

While on the inpatient rotation, one H&P is due for submission each Friday for a minimum of 3 inpatient H&Ps (one a week).  While on inpatient the first 3 weeks of the clerkship, a 4th H&P may be submitted if the student has a patient appropriate for write-up.  This eliminates the need for an outpatient H&P.  Otherwise, one outpatient H&P is required as well.  All H& P’s must be written within 24-hours of the patient’s admission.

 

The absolute deadline for the last H&P submission is before 4:30 pm Tuesday of the last week of the clerkship. Meeting this deadline is required in order to receive honors.

 

Mentors provide feedback on the H&Ps—therefore it is important to submit H & Ps weekly throughout the inpatient rotation. Submitted H & Ps should be from patients whom the student has actively participated in the history and physical examination, not those that the student only observes. 

 

The outpatient H&P should be written on a patient from subspecialty clinic.  This allows the student to see and make connections between the patient’s clinical presentation and the underlying pathophysiology of the disease process.  The write-up for a patient with a problem such as a seizure disorder, for instance, gives the student the opportunity to research the literature and ultimately understand more about a specific disease and/or diagnosis. 

 

Students must be proactive in taking responsibility for notifying the faculty member when he/she needs a patient for an H & P.