Pediatric Neurosurgery

Curriculum       

1. Rotate 4 months on a pediatric rotation during the PGY3 year
2. Attend all required pediatric conferences.
3. Take call as scheduled by the pediatric chief resident.
4. Participate in outpatient clinics and inpatient consultations.

Goals and Objectives

To provide an educational pediatric neurosurgery experience in patient care activities compliant with ACGME’s required competencies.  The resident will gain knowledge in the anatomy, physiology, pathophysiology and presentation of diseases in children which a neurosurgeon may be called upon to diagnose and treat. 

The resident will function as an integral member of the affiliated pediatric program under the direction of that program’s faculty.  The resident will prepare lectures, conferences, journal clubs, and morbidity and mortality reviews at the affiliate program.  Literature reading from text books, journals and computer-based learning may be expected.

Competencies

Medical Knowledge - During the pediatric rotation the resident will become competent in:

• Embryologic development of the central nervous system and its application to clinical pediatric neurosurgical patient disease processes.
• Developmental neuroanatomy, neurophysiology and neuroradiology as a foundation for clinical problem solving and decision making in pediatric patients.

• ER evaluation and management of head injury, spine/spinal cord injury, shunt malfunction/infection and postoperative medical/surgical complications.

Patient Care and Assessment - During the pediatric rotation the resident will become competent to:

• Performing comprehensive neurosurgical histories and physicals on pediatric patients with elective, traumatic and emergency neurosurgical diseases/disorders and develop comprehensive daily progress notes/documentation.

• Selecting appropriate utilization and interpretation of diagnostic studies (CT/MR) pertinent to the pediatric population.

• Conducting outpatient/clinic evaluation and followup of pre and postoperative children to include history-taking skills, general and neurological examination skills, the development of an appropriate workup, plan of management and providing for appropriate followup of surgical and nonsurgcial pediatric patients.

• Critical care management of ill, injured, or postoperative children with special emphasis on pediatric ventilator and medication issues

Practice Based Learning - During the pediatric rotation the resident will become competent in:

• Technical proficiency across the surgical spectrum of common pediatric neurosurgical disorders – hydrocephalus, craniosynostosis, tethered cored syndrome, tumors, and spinal injuries/anomalies
• Assisting in major surgical procedures and achieve competency in:  basic opening and closing techniques in pediatric patients, pediatric head injury and spine injury management, ventriculoperitoneal shunting, evaluation and management of spinal dysraphism, ventriculostomy and intracranial pressure monitoring, lumbar puncture, ventilator management, nutritional management, arterial line placement and halo placement.

Systems Based Practice - During the pediatric rotation the resident will become competent in:

• Participation/preparing for lectures, conferences, journal clubs and morbidity and mortality reviews comparing and contrasting adult versus pediatric neurosurgical disease/disorders with respect to evaluation and management.
• Utilizing current literature and research from text books, journals and computer-based learning experiences on pertinent pediatric neurosurgical issues.

Interpersonal and Communication Skills - During the pediatric rotation the resident will become competent in:

• Effectively communicating with affiliate staff.

Professionalism - During the pediatric rotation the resident will become competent in:

• Maintaining a professional relationship with affiliate staff at all times.

Evaluation        

At the end of this rotation, the pediatric neurosurgery faculty at Children’s Hospital of Pittsburgh (and any other outside facilities) will carefully and thoroughly evaluate the resident’s performance to ensure that fundamental competencies are established in this area of neurosurgical practice.  Part of this evaluation includes a review of the resident’s involvement as a primary or assistant surgeon in pediatric neurosurgical cases.