Clinical Training
During the clinical rotations, our objective is to expose the trainees to a wide variety of clinical and social situations. Early in the training there will be very close supervision of all clinical decisions and procedures. Gradually, as deemed appropriate for each individual trainee, increased responsibility will be given. By the second year, this will include supervision of the pediatric residents and an appropriate level of independent functioning. Trainees will assume responsibility for patient care and make critical decisions, including during stressful situations. Critical care faculty will always remain available for advice, support, and physical presence. Trainees will also be given ample opportunity to perform all procedures currently performed in critical care medicine. Finally, education will be provided and emphasis will be placed on the practice of evidence-based medicine.
In the first year of training, the majority of the emphasis will be placed on clinical time. Steadily increasing patient care and supervisory responsibilities will be given over the course of the year. Nine of the first twelve months will be spent on clinical duties, which includes two one-month rotations with anesthesia and one month on the trauma service. The remaining three months will be spent on research activities. In the first year, trainees will be encouraged to participate in any and all active research projects in the department and the laboratory of Dr. Thomas Shaffer. Dr. Shaffer is a renowned researcher in the field of pulmonary physiology and novel modes of mechanical ventilation. He has recently joined our institution as Director of the Nemours Research Lung Center at the Alfred I. duPont Hospital for Children. He has agreed to mentor one fellow per year in his well-equipped laboratory. In addition, trainees will receive education in developing hypotheses, designing a protocol, and statistical analysis. All trainees will participate in a statistics course given by Dr. Joseph Glutting, our statistical consultant. By the end of the first year, the trainees will be expected to choose a specific area of research interest and a research mentor. In addition, trainees will participate in all administrative meetings (QA, M&M, etc?).
The second year of training will have equal emphasis on clinical and research activities. Trainees will spend five months on clinical duty which includes two one-month rotations in the cardiac intensive care unit. They will have increased responsibility and independence for both the care of patients and the supervision of pediatric residents. Under the supervision of a research mentor, they will begin at least one non-clinical research project.
The third year of training will emphasize research. Trainees will have four months with clinical duties and eight months for research activities. On the clinical side, trainees will essentially function independently and supervise not only pediatric residents but junior critical care trainees as well. Of course, a critical care faculty member will always be available for backup. On the research side, trainees will be expected to complete their research project(s), author a manuscript, and submit it to a peer-reviewed journal.
Teaching skills will be developed through the independent preparation of lectures as well as bedside teaching. Trainees will be expected to provide several lectures per year to the residents, students, and critical care nurses. Critical care faculty will be in attendance to provide feedback and support for the trainee. All trainees will also become PALS instructors.
