Innovative Programs at Stanford Pediatrics
The Coaching Initiative is an innovative approach to providing longitudinal assessment and feedback to residents throughout their training, and to help residents develop skills of lifelong learning and self-reflection. Each resident is assigned a specific Faculty Coach who observes and guides that resident across multiple rotations, inpatient and outpatient settings, and training years. The Coach observes the resident in multiple clinical situations (rounds, clinic, initial H&P, handoffs, supervisory encounters, care conferences, and others) and provides specific and directed feedback aimed at strengthening clinical skills. There are eight Faculty Coaches, and each Coach oversees approximately 10 residents.
The Scholarly Concentrations were created to give residents more formalized training and mentorship in one of six scholarly areas:
- Basic Science
- Clinical Research
- Community Engagement and Advocacy (StAT program)
- Medical Education
- Quality and Process Improvement
- Global Health
Our goal is to help develop leaders in pediatrics, and we recognize that in-depth training, experiential learning through a significant scholarly project, and career development allows our residents to see how scholarship might fit into a longer term career plan.
Starting in 2014, we have added an elective rotation at Watsonville Community Hospital (in Watsonville, CA, 1 1/4 hours from Stanford, along the California coast), where our junior and senior residents can spend a month working as a Co-Attending, caring for pediatric and neonatal patients, on the wards, level 2 nursery, ED, and in follow-up clinic at the FQHC clinic on-site. This rotation allows residents to have incredible autonomy in a community setting, better understanding how to care for a wonderful population of patients, including a large migrant farm working community. Residents are backed up by Stanford Children's Health hospitalists. Housing is provided.
Teaching Senior Rotation
We believe that all residents play a vital role in teaching in residency and in the future. We are only one of 5-6 residency programs in the country to have a required Teaching Senior Rotation! It is one of our most popular rotations, and allows each senior resident to further develop his/her abilities to teach in a variety of settings and give feedback to a variety of learners. The Teaching Seniors give morning report weekly, do small group teaching throughout the month with a group of students, lead physical finding rounds, and observe medical students on rounds and in clinic and give feedback to them.
Understanding our role in quality improvement and performance improvement is important to our role as leaders in healthcare systems. As such, we have a required QI rotation to allow residents hands-on, experiential learning in improving real systems of care at LPCH. Each year, the junior class chooses a QI project to work on together, throughout the course of their junior year. These projects have led to significant systems-improvement at Stanford and LPCH, and have also been presented nationally at the Pediatric Academic Societies (PAS) meeting.
Initial Pilot Site for the National Pediatric Nighttime Curriculum
Stanford Pediatrics has had a nighttime curriculum since 2005. In 2011, a number of pediatric educators at Stanford and around the country developed the National Pediatric Nighttime Curriculum, and it was piloted at Stanford in the Spring of 2011, before being piloted at 89 sites (46% of residence programs) in the Summer/Fall of 2011.
IPASS Handoff Study Site
We were one of the ten national sites for the NIH-funded IPASS Handoff Study, and we were one of the first two sites to actually pilot the curriculum. Through this endeavor, our residents have felt much more prepared for giving and receiving handoffs. The study investigators are currently analyzing the data to better understand the impact of this curricular intervention on actual patient safety. And at this point, we have extended the curriculum to pediatrics Sub-I’s and Fellows.
Intern Boot Camp
Intern Boot Camp is a novel program that allows pediatrics interns to meet each Friday morning for protected time to further develop vital abilities in being a physician leader. Sessions have included:
- How to Lead a Team
- How to Learn as a Busy Resident
- How to Think Critically
- How to Tell a Story Succinctly
- How to Prioritize Patient Care Activities/How to do Contingency Planning
- How to Manage Conflict
- How to Give Feedback
- How to Teach as a Busy Intern
- How to Survive Intern Year
- Introduction to the Scholarly Concentrations
Junior/Senior Morning Report
Junior/Senior Morning Report occurs once/week (Tuesdays) and allows Medical Students/Interns and Juniors/Seniors to have separate morning reports that best reach their needs. For the Junior/Senior Morning Report, twice/month, the ED junior resident shares an interesting case which is discussed by the group at a higher level. The other two sessions each month allow juniors and seniors to delve into other important topics: controversies in ethics, professionalism, leadership, career development, new clinical guidelines, and other important topics.