FOD 5: Assessing, diagnosing, and managing patients with common pediatric problems

Key Features

• This EPA includes performing a comprehensive and/or targeted history and physical examination for a patient with a new presentation or an exacerbation of a pre-existing illness that is common in pediatric care.
• It also includes developing a differential diagnosis and initial management plan, and presenting the case to a supervisor.
• This EPA does not include assessing and managing patients who are critically ill or have complex multisystem problems.

Assessment plan

Direct observation or case review by supervisor, subspecialty resident or senior resident

Use Form 1. Form collects information on:

• Type of observation: direct; case review
• Event observed (select all that apply): history; physical; diagnosis; management plan
• Age: neonate; infant; preschool; school age; adolescent
• Setting: inpatient; outpatient; emergency department; community; on call/after hours
• Type of condition: respiratory; gastrointestinal; ID; cardiac; rheumatic/musculoskeletal; hematology/oncology; endocrine; neurology; renal/genitourinary; otolaryngology/ophthalmology; dermatology; genetic; mental health; developmental/behavioural/psychosocial; allergy/immunology
• Presentation: dehydration; fever; respiratory distress; other (please specify)

Collect 10 observations of achievement

• At least 5 direct observations of a component of history and/or physical
• At least 1 from each age group
• At least 5 types of condition
• At least 1 observation for each of respiratory distress, dehydration and fever
• At least 5 observations by an attending physician
• At least 5 different observers

CanMEDS milestones

1. ME 2.2 Elicit a history, including the perinatal history as relevant
2. COM 2.1 Conduct the interview in a patient-centred manner
3. ME 2.2 Perform the physical exam in a manner that minimizes discomfort or distress, without excluding key elements
4. ME 2.2 Perform a physical examination relevant to the presentation
5. ME 2.2 Adapt the clinical assessment to the child’s age and development
6. COM 2.3 Seek and synthesize relevant information from other sources (e.g., family, medical record)
7. ME 2.2 Develop a differential diagnosis relevant to the patient’s presentation
8. ME 1.3 Apply knowledge of the limitations of blood volume on laboratory testing and the challenges of medical imaging in children
9. L 2.1 Consider costs when choosing care options
10. ME 2.2 Select and/or interpret appropriate investigations
11. ME 2.2 Synthesize and interpret information from the clinical assessment
12. ME 2.4 Develop a plan for initial management