How could the knowledge I’ve gained here be applicable in other rotations/disciplines?

In this rotation, I got a chance to exam and treat the pediatric patients with different disorders and different stages of ages. First, I learnt how to get information from patients with different age, including newborns, young children, old children, and adolescences. For example, when I have to talk with adolescences alone and when I have to talk with them and their parents. I can distinguish that what type of information I cannot share with their parents. I also learnt how to do the physical exams for the young kids, totally different from those for old children. Also, I practiced how to perform a detailed specific evaluation, make a list of possible differential disorders, set up a treatment plan including tests, interventions, and medications for pediatric patients. In addition, I improved my skills for specific conditions, such as child abuse, preterm newborn evaluation, and monitoring.

Types of patients you found challenging in this rotation and what you learned about dealing with them

Pediatric patients had always been a challenging population for me. They could be the least cooperative patients. I would have to rely on the parents for history-taking. At the beginning of the rotation, I found it difficult to perform physical examination when the child was uncooperative, fussy, and irritated, especially the ear exam. I had learned a lot about dealing with pediatric patients as well as calming them down during this rotation.  In patients that refused physical exam, we could build rapport with the patients by listening to parent’s heart, then I would also let the patient listen to mine. It is important to spend time with the children and build trust so that we could perform physical exam smoothly.

How your perspective may have changed as a result of this rotation (e.g. elderly patients, kids, IV drug users, etc).

My perspective has changed for pediatric population as a result of this rotation. Before the rotation, I thought pediatric patients would be very difficult to manage compared to the adult populations because they were not able to provide a full history and they could be very uncooperative. They could also be easily distracted when they were being exam. I have realized when interviewing the pediatric population, skills such as communicating on the child’s level is important. For examples, learning the child’s name in advance, physically getting down to the child’s level, or giving the child a helping role.

What do you want to improve on for the following rotations? What is your action plan to accomplish that?

For this rotation, I had a chance to expand my experience and knowledge in dermatology. However, I would like to complete more procedures listed in the procedure log. Because I do not have a chance to complete too many procedures. For example, I would like to observe and practice procedures such as lumbar puncture, paracentesis and thoracentesis. I did not get to see a lot of those in my previous rotations. Lumbar puncture is important to perform because it can help diagnosis serious infection such as meningitis and other disorders of the central nervous system. Therefore, I plan to review my class notes and study some online videos. The more practical procedures I do, the more I will be able to master and handle them well.