PGY1: Pediatric Pulmonary (Peds)
Riley Hospital at Indiana University Health
Preceptors
Rebecca Pettit, PharmD, MBA, BCPS
Office: 948-9362/Pager: 312-8681
General Description
The pediatric pulmonary rotation is a 1 month rotation experience at Riley Hospital for Children. The
pulmonary service consists of two services that care for the pediatric pulmonary patients on the unit.
Each medical team consists of an attending physician, PGY1, PGY2 or PGY3 medical residents. The
clinical pharmacy specialist, nutritionist, and social worker care for both teams. Pharmacy residents
and other health professionals in training also participate when assigned to the pulmonary teams.
Typical patient load between the two teams is 20-40 patients. Depending on degree of experience and
time in residency the resident maybe assigned to 1 team or both teams
The clinical pharmacy specialist on the team is responsible for ensuring safe and effective medication
use for all patients admitted to the team. Routine responsibilities include: reconciling medications for
patients, analyzing patient information, designing, implementation and evaluation of evidence based
monitoring plans, the redesign of regimens and monitoring plans as needed, documentation of direct
patient care activities, pharmacokinetics, problem identification and problem solving, and medication
counseling. The pharmacist will also provide drug information and education to healthcare
professionals as well and patients and caregivers.
.
Disease States
The resident will be expected to gain proficiency through direct patient care experience for
common diseases including, but not limited to:
• Repiratory disorders
• Asthma, cystic fibrosis, respiratory syncytial virus, bronchiolitis, chronic respiratory
failure
• Gastrointestinal disorders
• GERD
• Endocrinologic disorders
• Cystic fibrosis related diabetes
• Infectious disease
• Pneumonia, otitis media
•
Other
• Allergic bronchopulmonary aspergillosis
Topic discussions and reading key articles will be used to help develop the resident’s patient care skills
for common disease states or acquiring knowledge about diseases seen infrequently on the service
Goals and Objectives
During the learning experience the resident will focus on the goals and objectives outlined below by
performing the activities that are associated with each objective. The resident will gradually assume
responsibility for all of the patients within the assigned unit. The PGY1 resident must devise efficient
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strategies for accomplishing the required activities in a limited time frame.
Achievement of the goals of the residency is determined through assessment of ability to
perform the associated objectives. The table below demonstrates the relationship between
the activities and the goals/objectives assigned to the learning experience.
Goals and Objectives
Competency
Area
GOAL R1.1
Objective R1.1.1
Objective R1.1.2
Activities
Objective
In collaboration with the health care team,
provide safe and effective patient care to a
diverse range of patients…following a
consistent patient care process.
The resident will participate in daily
multidispilinary patient care rounds.
(Applying) Interact effectively with health care The resident will work up patients
teams to manage patients’ medication therapy. prior to rounds to effectively give
(Applying) Interact effectively with patients,
family members, and caregivers.
recommendations to the team
during rounds.
The resident will provide
patient/family member education
for home IV antibiotic discharges,
anticoagulation, and other
discharge medications as needed.
The resident will also conduct
medication histories and
medication reconciliation on
patients as needed.
Objective R1.1.3
(Applying) Collect information on which to base Residents will work up patients
safe and effective medication therapy.
prior to rounds and in a manner to
Objective R1.1.4
effectively discuss patients with
presceptors and provide patient
care.
Residents will be expected to
assess patient information to
develop a pharmaceutical regimen
and plan.
Objective R1.1.5
(Analyzing) Analyze and assess information on
which to base safe and effective medication
therapy.
(Creating) Design or redesign safe and effective The resident will be expected to
patient-centered therapeutic regimens and
assess primary literature and other
monitoring plans (care plans).
drug references to design a safe and
effective regimen and monitoring
plan. These plans will be discussed
the the preceptor.
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Objective R1.1.8
(Applying) Demonstrate responsibility to
patients.
GOAL R4.2
Effectively employs appropriate preceptors’
roles when engaged in teaching.
Objective R4.2.1
(Analyzing) When engaged in teaching, select a If a pharmacy student is on service the
preceptors’ role that meets learners’
PGY1 resident will engage in the
educational needs.
precepting and teaching of the student.
Objective R4.2.2
(Applying) Effectively employ preceptor roles,
as appropriate.
The resident will be available to all
service areas until all pharmacy
related issues are addressed and
resolved.
If students are present the resident will
be responsible for leading topic
discussions.
Preceptor Interaction
Daily:
8:00 - 8:30
schedule
1:00 – 2:00
Pre-rounds with resident – in person or over the phone depending on the
Preceptor available in office for topic discussions,
reviewing progress notes, patient updates, etc. – depending on schedule
these times may change and the resident will be notified.
Communication:
A. Daily scheduled meeting times: Residents to prioritize questions and problems to discuss
during scheduled meeting times as listed above.
B. E-mail: Residents are expected to read e-mails at the beginning, middle and end of each day at
a minimum for ongoing communication. This is appropriate for routine, non-urgent questions
and problems.
C. Office extension: Appropriate for urgent questions pertaining to patient care.
D. Pager: Residents to page preceptor for urgent/emergency situations pertaining to patient care
E. Personal phone number: Provided to resident at time of learning experience for emergency
issues.
Expected progression of resident responsibility on this learning experience:
(Length of time preceptor spends in each of the phases will be personalized based upon resident’s
abilities and timing of the learning experience during the residency training year)
Day 1: Preceptor to review learning activities and expectations with resident.
Week 1 (first half): Resident to work up approximately 1/3 of the team’s patients and present to
preceptor daily. Preceptor to attend and participate in team rounds with resident, modeling
pharmacist’s role on the health care team.
Week 1 (second half): Resident to work up approximately half of the team’s patients and discuss
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problems with preceptor daily. Preceptor to attend team rounds with resident, coaching the resident to
take on more responsibilities as the pharmacist on the team.
Weeks 2-5: The resident is expected to take over the responsibility of working up all of the team’s
patients, continuing to discuss identified problems with preceptor daily. Once the resident is able to
take responsibility for all patients assigned to the team, the preceptor will no longer attend team
rounds, but will continue to facilitate the resident as the pharmacist on the team.
Required Attendance
• Daily multidisciplinary rounds at 8:30 am Mon, Thurs, Friday and 9:00 am on Tuesday and
Wednesday
• Pediatric Pulmonary Lectures – Tues 0800 (Second Tuesday 0730)
• Pediatric Grand Rounds – Wed 0800
• Pediatric Journal Club
• Pharmacy Grand Rounds – 3rd Tuesday of month 1200
• Pharmacy Resident Topic Discussions
• Optional Meetings include: Pulmonary Research Conference – Monday 12:00
Required Projects
• The resident is required to complete one project as determined by the preceptor. This project
is due by the end of the rotation.
Required Presentations
• The resident will be required to give one disease state presentation and/or journal club to
preceptors, medical team, nurses, or other trainees during the month.
•
Required Readings: Review during the 1st 7 days of rotation the following guidelines:
o Pediatric asthma guidelines: http://www.nhlbi.nih.gov/guidelines/asthma
o Cystic Fibrosis Pulmonary Guidelines: Chronic Medications for Maintenance of
Lung Health: Mogayzel PJ, et al. Am J Respir Crit Care Med 2013;187:680-689.
o Cystic Fibrosis Pulmonary Guidelines: Treatment of Pulmonary Exacerbations:
Flume PA, et al. Am. J. Respir. Crit. Care Med. 2009 Nov;180(9):802-8. Epub 2009
Sept. 3
Evaluation
PharmAcademic will be used for documentation of scheduled evaluations (see chart below). The
resident and the preceptor will independently complete the assigned evaluation and save as draft. The
resident and the preceptor will then compare and discuss the evaluations. This discussion will provide
feedback both on performance of the activities and the accuracy of the resident’s self-assessment skills.
Evaluations will be signed in PharmAcademic following this discussion.
• Summative evaluations: This evaluation summarizes the resident’s performance throughout the
learning experience. Specific comments should be included to provide the resident with information
they can use to improve their performance in subsequent learning experiences.
• Preceptor and Learning Experience evaluations must be completed by the last day of the learning
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experience.
•
The preceptor and resident will meet each week to evaluate the progress of the week, provide
feedback, and discuss goals for the following week.
What
Summative
Preceptor/Learning Experience
Evaluation
Who
Preceptor
Resident
When
End of week 4
End of week 4
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