Key Features

This EPA focuses on recognizing when a patient requires timely intervention and/or an increased level of care, and initiating necessary interventions including pediatric basic life support and advanced life support, when needed.
It includes identifying when further assistance is required and promptly seeking it.
This EPA does not include the delivery room setting and does not include leading the resuscitation or ongoing management of the patient.
This EPA may be observed in simulation.

Assessment Plan

Direct observation or case review by supervisor or senior resident

Collect 5 observations of achievement

At least 1 neonate
At least 1 infant
At least 1 preschool, school age or adolescent
At least 3 different clinical presentations
No more than 2 simulations
At least 1 observation by a pediatrician
At least 3 different observers

Key Features

This EPA focuses on recognizing the features of normal and abnormal fetal to neonatal transition and responding appropriately, providing standard newborn care and initiating basic neonatal resuscitation (NRP), when needed.
It includes identifying when further assistance is required and collaborating with the neonatal resuscitation team.
This includes term and near term deliveries where there are no expected congenital anomalies. This EPA does not include high risk deliveries, antenatal consultation/care, care beyond initial management of resuscitation (feeding, ongoing NICU care), or nursery care.
This EPA may be observed in the delivery room or in a simulation setting.

Assessment Plan

Direct observation by supervisor, which may include input from members of the neonatal resuscitation team

Collect 5 observations of achievement

No more than 2 in simulation
At least 3 initiations of resuscitation
At least 2 different observers

Key Features

This EPA includes providing care to healthy newborns and includes the routine screening newborn exam, and discharge counselling.
This EPA is divided into two parts: initial assessment of newborns; and, discharge assessment.
The discharge assessment aspect of this EPA includes planning follow-up and providing anticipatory guidance and counselling for healthy newborn care.

Assessment Plan

Direct observation by supervisor, senior resident, nurse practitioner, or advanced care nurse

Collect 5 observations of achievement

At least 2 different observers

Key Features

This EPA includes providing care to healthy newborns and includes the routine screening newborn exam, and discharge counselling.
This EPA is divided into two parts: initial assessment of newborns; and, discharge assessment.
The discharge assessment aspect of this EPA includes planning follow-up and providing anticipatory guidance and counselling for healthy newborn care.

Assessment Plan

Direct observation, case presentation or review of written documentation by supervisor, senior resident, nurse practitioner, or advanced care nurse

Collect 5 observations of achievement

At least 2 different observers

Key Features

This EPA includes performing a comprehensive and/or targeted history and physical examination for a patient with a new presentation.
It also includes developing a differential diagnosis and initial management plan, and presenting the case to a supervisor.
Examples of common problems include neonatal abstinence syndrome, poor weight gain, hypoglycemia, hyperbilirubinemia, respiratory distress and the neonate at risk for sepsis.

Assessment Plan

Direct observation or case review by supervisor

Collect 3 observations of achievement

At least 2 different presentations

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 preexisting 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

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

Key Features

This EPA includes identifying opportunities and providing developmentally appropriate anticipatory guidance and preventive care for patients and their families.
This includes guiding healthy habits (e.g., diet and nutrition, physical activity, sleep), preventing injuries and illness, advising regarding immunizations for children and contacts, performing appropriate screening, and supporting mental health.
This EPA also includes applying knowledge of social determinants of health, dynamics of family functioning (including parental mental health), and the specific challenges faced by vulnerable populations.

Assessment Plan

Direct observation and/or case review by supervisor, subspecialty resident, senior resident, nurse practitioner or physician assistant

Collect 5 observations of achievement

At least 1 direct observation
At least 1 from each age group
At least 1 chronic disease
At least 1 vulnerable population
At least 2 different observers

Key Features

This EPA includes determining which procedures are necessary and appropriate to the situation.
Procedures include: bag valve mask ventilation; cardiopulmonary resuscitation (ventilation and massage, defibrillation in core); intraosseous injection; lumbar puncture in neonates and infants; changing tracheostomy tubes for obstruction or decannulation; needle thoracostomy in neonate.
Some procedures may be observed in a clinical or simulation setting, including Pediatric Advanced Life Support (PALS) or Neonatal Resuscitation Program (NRP) courses, and/or mock codes.

Assessment Plan

Direct observation by supervisor

Collect 12 observations of achievement (those marked with an asterisk may be observed in simulation)

At least 4 bag valve mask ventilation in neonate/infant (no simulation), preschool* and school age/adolescent*
At least 2 cardiopulmonary resuscitation*
At least 1 changing tracheostomy tubes for obstruction or decannulation*
At least 2 intraosseous injection*
At least 2 lumbar punctures in neonates/infants
At least 1 needle thoracostomy in neonate* (clinical setting recommended, but simulation is acceptable)

Key Features

This EPA focuses on the application of communication skills and strategies to convey information, engaging the patient and/or family in shared decision-making.
This EPA also includes teaching the patient and/or family about the diagnosis and management.
This does not include complex situations such as discussions involving disclosing serious diagnoses, end-of-life decision-making, or suspected child maltreatment.

Assessment Plan

Direct observation by supervisor, or Core or TTP resident

Collect 5 observations of achievement

At least 1 neonate, infant or preschool
At least 1 school age
At least 1 adolescent
At least 2 observations by supervisor
At least 2 different assessors

Key Features

This EPA focuses on the application of written communication skills in a variety of formats such as assessment/progress notes; consult letters; discharge summaries; consult requests.
This includes a synthesis of the pertinent clinical findings, investigations, management plan, and clinical reasoning, as well as clear documentation of the plan for further care.
Any documents submitted for review must be the sole work of the resident.

Assessment Plan

Review of documentation by supervisor, clinical associate, subspecialty resident or senior resident

Collect 4 observations of achievement

At least 1 admission note
At least 1 discharge summary
At least 1 progress note
At least 1 consult letter

Key Features

This EPA focuses on communicating acute and ongoing information about a group of patients with varying complexity between colleagues at times of transition in physician responsibility.
It includes handover when going off duty, at the end of a rotation, and/or at the end of call shifts.

Assessment Plan

Direct observation by supervisor, or Core or TTP resident, which may include review of sign-out sheet, electronic document or other communication tool

Collect 2 observations of achievement

Key Features

This EPA focuses on transferring patients from one hospital setting to another or to other health care facilities, and discharging patients.
This includes summarizing the hospital course and any remaining issues, coordinating ongoing care/follow-up and providing all needed documentation (e.g., summary, prescription) in a timely manner.
This also includes oral or written transfer of information and responsibility of patient care from one practitioner to another.
This EPA does not include complex patients (Core).

Assessment Plan

Direct observation and/or case review by supervisor, subspecialty resident, senior resident, nurse practitioner or other with expertise in transitions

Collect 4 observations of achievement

At least 1 of each transition type
At least 2 different observers

Foundations to Discipline