Fellows as educators

Fellows have multiple opportunities to develop and hone their skills as educators through the following:

Daily Monday to Thursday mornings: Didactic sessions for pediatric residents in the NICU while on clinical service. Bedside teaching on daily rounds while on clinical service. Formal and informal teaching of residents, medical students, nurse practitioner students and bedside nurses while on-call.
Weekly Each fellow presents a clinical case conference once per year during our Newborn Medicine weekly division conference. This presentation encourages fellows to reflect on a clinical case in their practice, read relevant literature and present the case succinctly to the fellows and faculty. Fellows work with faculty clinical mentors and the program directors to develop their presentations.

Senior fellows present an interactive board review topic once per year. Each fellow receives a copy of a neonatology board review book upon starting fellowship.

Fellows have additional opportunities to present clinical cases and relevant literature at twice monthly Complex Case conference and monthly ECMO conference.
Monthly Fellows can become NRP instructors and teach NRP to pediatric residents at the monthly NRP review.

Fellows present cases in our monthly Morbidity Mortality and Improvement Conference in conjunction with faculty mentors as well as colleagues in the Department of Pathology.

Fellows take part in monthly Labor and Delivery Quality Improvement meetings, discussing delivery room courses and working to improve system-based issues.
Yearly The Washington University Teaching Physician Pathways is a School of Medicine wide opportunity to develop knowledge, skills and experience needed to excel as a clinician-educator. The program includes classroom and clinical teaching opportunities and mentorship. Fellows apply in the second year of fellowship and complete coursework during the third year of fellowship.

Didactic conferences

Weekly conferences

Tuesday
2–4 p.m. Department of Pediatrics Fellow Forum, curriculum relevant to fellowship year of training. The conferences occur September through May.
Wednesday
1-2 p.m. Newborn Medicine Division Conference (include any one of the following topics)
  • Clinical case conferences that promote the fellow’s skill as an educator.
  • Morbidity and mortality conferences help understand the mechanism of death of neonates in collaboration with the pediatric pathologists. Patient Safety and Quality improvement is also the focus of these conferences.
  • Presentation and discussion of proposed guidelines and clinical pathways for patient care.
  • Diversity, equity and inclusion topics.
  • Research presentations by senior fellows.
  • Guest speakers invited on behalf of the Division of Newborn Medicine.
2-3 p.m. Newborn Medicine Fellows’ Conference (include any one of the following topics)
  • These conferences aim to fulfill the content outline published by the ABP neonatal-perinatal medicine subspecialty board.
  • Faculty lectures from Pediatric Subspecialty and Newborn Medicine faculty
  • Evidenced-based medicine journal club
  • Fetal and neonatal pharmacology lectures
  • QI methodology
Friday
9:15 a.m. Pediatric Grand Rounds – Lectures are on a wide range of topics by Washington University faculty and invited speakers. These are attended by many members of the St. Louis pediatric community, including full-time faculty, medical students, house staff, nurses and hospital administrators. Multiple endowed lectureships provide support for the most sought-after pediatric speakers in the world.
12 p.m. Labor and delivery QI, ECMO education, Neonatal Neurology, Board Review

Annual conferences

May Department of Pediatrics Research Retreat
Allows current fellows to present their research projects. Incoming first year fellows learn about the research in the Department of Pediatrics and have the opportunity to meet potential mentors.
July NICU Fellow Boot Camp
Boot camp is organized by Newborn Medicine faculty for our new fellows. This camp provides hands-on opportunities to learn or review common and uncommon NICU procedures, ventilation strategies and fundamentals of arranging neonatal transport trips. We regularly collaborate with faculty and fellows from Saint Louis University as part of the boot camp.

NICU Fellow Boot Camp
ECMO boot camp is organized by Newborn Medicine faculty for our new fellows. This camp provides hands-on and didactic education on fundamentals of the ECMO circuit and the care of infants who require this life-saving therapy.

Advanced simulation training

Advanced simulation training sessions augment the fellows’ educational experience by providing hands-on, high-fidelity simulation experiences in the management of complex neonatal problems.

The following topics are covered in the Advanced Simulation Curriculum and are based on the
American Board of Pediatrics Neonatal–Perinatal Content Outline. The sessions encourage reflective thinking, good team communication and deliberate practice of technical skills.

Educational goals for fellow simulation training including the following:

Neonatal Resuscitation

Airway

  • Know the proper approach to airway management in the delivery room
  • Know the potential complications of airway management in the delivery room
    and know their management
  • Know the current recommendations regarding suctioning meconium from the
    airway during and following delivery

Ventilation and oxygenation

  • Know the indications for assisted ventilation, including continuous positive
    airway pressure, immediately after birth and how to assess its effectiveness
  • Understand how to use self-inflating and flow-inflating bags or T-piece
    resuscitators to provide assisted ventilation immediately after birth
  • Know indications for and proper administration of supplemental oxygen
    immediately after birth

Circulatory support

  • Know the indications for, techniques, and potential complications of chest
    compression immediately after birth
  • Know the indications for and management of intravascular fluid volume
    replacement immediately after birth

Pharmacologic management

  • Know the indications, contraindications, and methods of administration of drugs used for neonatal resuscitation
Airway obstruction
  • Know the clinical features of an infant with airway obstruction
  • Plan appropriate diagnostic evaluation and management for an infant with airway obstruction
Respiratory distress
  • Know the clinical strategies and therapies used to decrease the risk and severity of RDS
  • Know the management of RDS, including surfactant replacement
Pulmonary hypertension
  • Recognize the clinical features and differential diagnosis of persistent pulmonary hypertension
  • Know the management of persistent pulmonary hypertension including assisted ventilation, pharmacologic approaches and ECMO
Air leaks

Recognize the clinical, laboratory and imaging features of air leaks

Congenital heart disease

Cyanotic heart defects

  • Know the evaluation and medical and/or surgical management and associated potential complications or adverse effects of such management for a cyanotic neonate
  • Recognize the clinical features and possible associated defects of a cyanotic neonate
Arrhythmias

Know appropriate management of common arrhythmias in the fetus and newborn
infant and understand the potential complications or adverse effects of approaches and drugs used

Shock

Recognize features and management of hemorrhagic, distributive, cardiogenic, obstructive and neurogenic shock

Fetal anomalies

Know how specific fetal anomolies such as airway abnormalities, abdominal wall defects, trachea-esophageal fistula, neuroal tube defects, or severe hydrocephalus alter delivery room management.

Educational Resources

A listing of additional resources available to pediatric residents