Experience, Goals and Objectives

PL-1 Experience, Goals, Objectives: 
The PL-1 rotation takes place in the second half of the academic year after the resident has completed at least one rotation in the NICU and has had training and experience in resuscitation and performing procedures on neonates. The resident works in tandem with a family practice intern and has responsibility for teaching third year medical students during the nursery portion of their pediatric clerkship. The goals and objectives for PL-1s are to:

• Become thoroughly familiar with the examination of the term newborn including common variations in physical findings
• Gain competence in managing the frequently encountered problems in term babies (hyperbilirubinemia, risk of sepsis, hypoglycemia, etc.);
• Acquire confidence in discussing with parents the care of their newborn including breastfeeding
• Gain knowledge of the neurodevelopmental examination in the neonate including the Brazelton examination.

PL-2 Experience, Goals, Objectives: 
The rotation for PL-2s occurs in the first half of the academic year. The resident assumes a more supervisory role, acts as a resource for the family practice intern and is a leader for student teaching. The goals and objectives for PL-2s are to:

• Be able to make more independent decisions about day to day patient management with appropriate consultation from the attending pediatrician
• Attain a level of expertise in interacting with new parents which allows for more awareness of family developmental and social issues
• Gain further experience with the Brazelton examination which should allow the resident to incorporate neurodevelopmental and temperamental factors into their Sdiscussions with parents.

Methods Used to Achieve Goals and Objectives

1. Direct patient care: Residents are responsible for the initial, daily, and discharge examinations of all babies on the UMass service, for charting, and for communicating daily with parents
2. Daily attending work rounds;
3. Didactic seminars: Faculty include attending pediatric generalists, nursing staff, developmental therapist, developmental pediatrician, social worker, and lactation counselor
4. Reading materials: A series of selected articles is available in the Nursery; the MHC has a comprehensive library, and specific texts are recommended
5. Video tapes used for patient education and for nursing inservice are available for resident use
6. The resident is expected to prepare a short presentation at the end of each rotation on a newborn topic of his/her choice.

Relationship to the NICU: 
Residents assigned to the newborn nursery do not have responsibilities in the NICU during the day but do take night call in the NICU every fourth night. (There is no night call responsibility for the newborn nursery by residents.)

Fourth year medical students can elect a PL-1 subintership which is similar to the PL-1 description or a clinical research project (4-8 weeks) with a neonatologist as the supervisor. All notes/orders are countersigned by PL-1/2, fellow or neonatologist.