Department of Pediatrics- Pediatric Residency Program

Resident Name . PGY ..

Date ..

Know/follow expected schedule and content of well

visits
Visit and organization and priority-setting
History and observational skills
Family centered care
Community/culturally centered care
HX & Physical exam (age appropriate)
Infant
Toddler/preschool
(incl prepubertal GYN)
School age
Teen
(incl prepubertal GYN)
Assessment and anticipatory care (age appropriate)
Nutrition/Diet
Elimination
Oral health
Development/School achievement
Reading books
Appropriate Computer, TV, Video use
Injury prevention
Discipline & Positive interactions between the
parent and child/adolescent
Constructive family communication and
relationships and parental health
Assessing & addressing parental mental
health
Physical activity and sports
Sexuality (all ages)
Prevention of substance use/abuse (middle
childhood, adolescence)
Violence prevention/anger management

NOTES-areas to
learn more about
and how I will do
this

Independent and
confident

Can manage and

RX most

PGY (YR)

Can assess most

Continuity Clinic CORE Topic List

Level when
expected to
assess and
RX fairly
independently

Beginning skills

Residents Competency Self-Assessment Form

PGY 1

1
2
3
1
1
1
1

1
1
1
1
1
1
1
2
3
3
3
3
3
3

Mentor Signature& Stamp:..

Source: Childrens Hospital of Dartmouth, 2009. Diane Kittredge, MD

Resident Self-Assessment Tool

( PGY Level expected for skill is listed in column 2)

Level when
expected to
assess and
RX fairly
independently
(PL YR)

Environmental health lead

Environmental health passive smoke
Environmental health other toxins
Screening for disease/disorder when, why, how,
interpretation
Neonatal screen results (Hearing, metabolic)
Iron deficiency screening (CBC, vs. HGB, vs.
EP)
Lead and EP screening
Hearing screening (PROCEDURE)
Tympanometry screening (PROCEDURE)
Vision screening (PROCEDURE)
Developmental screening tests (PROCEDURE)
BP screening (PROCEDURE)
Obesity/diabetes screening (lipid profile, BS,
OGTT, Hemoglobin A1C)
STD screening
Depression screening (PROCEDURE)
Vanderbilt screening test for ADHD
(PROCEDURE)
PPD - tuberculosis screening (PROCEDURE)
IMMUNIZATIONS-timing, risk/benefit, counseling and
administration (PROCEDURE)
Routine IM and oral
Routine SC
Special or new
Handle parents with concerns/refusals
VAER vaccine adverse reporting system
TOPICS BY SPECIALTY
ALLERGY/IMMUNOLOGY
Approach to does my child have allergies?
Prevention through early habits
Asthma - chronic management
Food allergies
CARDIOVASCULAR
Heart murmur-functional
Family HX early CVD
CV Risk prevention education
Dental
Fluoride when, dose, why

Can assess
most
Can
manage and
RX most
Independen
t and
confident
NOTESareas to
learn more
about and
how I will
do this

Resident Name . PGY ..

Date ..
Beginning
skills

Department of Pediatrics- Pediatric Residency Program

1
2
3

1
1
1
1
1
1
1
1
2
2
2
2
2

1
1
2
2
2

2
2
1
3
1
1
2
1

Mentor Signature& Stamp:..

Source: Childrens Hospital of Dartmouth, 2009. Diane Kittredge, MD

Resident Self-Assessment Tool

( PGY Level expected for skill is listed in column 2)

Level when
expected to
assess and
RX fairly
independently
(PL YR)

Caries-prevention, early recognition

Bite abnormalities/recognition
Dermatology
Acne
Atopic dermatitis
Pigment changes (loss; moles)
Warts and molloscum
Endocrine/Metabolic
Sexual Maturity Rating (Tanner staging)
Weight disturbances, recognize when endocrine
cause may be in the differential DX
Obesity risk, counseling, intervention
Length disturbances, recognize when endocrine
cause is in the differential DX
Variations in timing of puberty
ENT
Nodes- ranges of normal
Tonsils-ranges of normal
TMs-normal variants
Risks for early hearing loss
Epistaxis, recurrent
Noisy breathing, snoring, persistent
GI/Nutritional
Breast feeding support, common issues
Breast feeding support, less common issues
Bottle feeding issues, formula, bottle overuse,
weaning
Constipation
GER -Spitting in infancy
Toilet training - BMs
Feeding struggles in toddlers
Functional belly pains
Eating disorders, early signs
GU/Renal
Voiding variations at different ages
Bedwetting- age, approach
Scrotal variations (hydrocele, hernia, varicocele,
discomfort)
Approach to UTI

Can assess
most
Can
manage and
RX most
Independen
t and
confident
NOTESareas to
learn more
about and
how I will
do this

Resident Name . PGY ..

Date ..
Beginning
skills

Department of Pediatrics- Pediatric Residency Program

2
3
2
2
2

1
2
2
2
2
1
1
1
1
2
2
1
2
1
1
1
2
2
2
3
2
2
2
1

Mentor Signature& Stamp:..

Source: Childrens Hospital of Dartmouth, 2009. Diane Kittredge, MD

Resident Self-Assessment Tool

( PGY Level expected for skill is listed in column 2)

Level when
expected to
assess and
RX fairly
independently
(PL YR)

Gynecologic
Contraceptive counseling
Approach to risk-taking behaviors (substance
abuse, eating disorder, sexual risks, etc)
Common menstrual disorders (Irreg, too heavy,
not yet)
Labial adhesions
STD screening and infections
Vaginal discharge prepubertal
Vaginitis, pubertal
Hematology/Oncology
Anemia, iron deficiency; w/up & prevention
Infections
Daycare and risk of infections
Anticipatory care, education re: common
infections
Travel precautions/vaccines

2
3
2
2
2
2
2
1
1
2
3

Musculoskeletal
Growing pains
Positional deformities feet, legs, back
Gait variations

2
2
2

Neurology
Headache, include recurrent
Head shape, unusual/positional

2
2

Ophthalmology
Amblyopia
Strabismus
Screen/interpreting visual acuity change/loss
Pharmacology/Toxicology
Counseling to prevent common drug poisoning
or overdose
Pulmonary
Chronic care- asthma
Psychology/Psychiatry/Develop/Behavior
Approach to developmental delay
Approach to behavioral concerns

Can assess
most
Can
manage and
RX most
Independen
t and
confident
NOTESareas to
learn more
about and
how I will
do this

Resident Name . PGY ..

Date ..
Beginning
skills

Department of Pediatrics- Pediatric Residency Program

1
1
1

2
2
Mentor Signature& Stamp:..
Source: Childrens Hospital of Dartmouth, 2009. Diane Kittredge, MD

Resident Self-Assessment Tool

( PGY Level expected for skill is listed in column 2)

Level when
expected to
assess and
RX fairly
independently
(PL YR)

Approach to discipline issues

Approach to school problems
Approach to sleep problems
Approach to somatic complaints
Behavioral issues w/ chronic disease
Approach to habits(thumb sucking, head banging)
Parenting problems
* Abuse risk
* Anger
* Depression
* Divorce
* Social/cultural isolation
* Substance- ETOH, illicit drugs
* Tobacco
Chronic care of pts with ADHD
Chronic care of pts with behavioral/MH
condition
Newborn/Infancy
Abnormal NB screen, f/up
Birth marks
Child care decisions, issues
Colic
Developmental Dysplasia of the Hips
FTT
Jaundice
Lactation issues post discharge
Umbilical cord problems/Qs
Chronic Disease
Serving as coordinator of care
Effects on siblings, parents
Child emotional response/stages by age
Community Resources

Can assess
most
Can
manage and
RX most
Independen
t and
confident
NOTESareas to
learn more
about and
how I will
do this

Resident Name . PGY ..

Date ..
Beginning
skills

Department of Pediatrics- Pediatric Residency Program

2
2
2
2
2
2
3

2
2

1
1
1
1
1
1
1
1
1
2
2
2
2

LIST or Discuss w preceptor chronic diseases in your patient panel

Mentor Signature& Stamp:..

Source: Childrens Hospital of Dartmouth, 2009. Diane Kittredge, MD