Rotation Orientation

The following is importation information about the DBP rotation. Trainees are expected to review this information prior to the start of the rotation.

There are some rotation characteristics that distinguish the DBP rotation from other pediatric rotations. 

1. Most DBP Clinics are constructed around an interdisciplinary team. As you work with these teams, you will learn how to collaboratively conduct patient evaluations and provide feedback to families. The ‘Direct Observation Checklist’ will be used to provide specific feedback to you about your conduct of clinical visits. 

2. Many DBP patients and families are receiving difficult diagnoses, like autism, ADHD, and global developmental delay. Residents are not expected to have all the answers for every family; you will learn over the course of the month how such information can be effectively communicated in person and in clinical reports. We do expect that you will become expert in collecting (via parent interview, questionnaires, medical and educational record review, child physical examination) all of the data needed to arrive at a diagnosis and to formulate a treatment plan.   

3. Many DBP patients and families are being referred and connected to needed services. The dictated report includes information that indicates the reasons for these referrals. You will be able to use structured dictation forms that will guide your patient dictations (HRIF Dictation Form, Development Consult Dictation Form, ASD Template, ADHD Template, Speech and Language Problems Template). Starting the second week of the rotation, we expect that residents will dictate about one outpatient letter for each DBP Clinic session.

The content of these letters includes the results of developmental assessments and indicates serice eligibility

The family receives a copy, so we emphasize the use of careful understndable wording. Please do not refer to parents as Mom or Dad. Please spell out acronyms when used the first time. Please use past tense when describing physical examination findings.

The DBP faculty person who supervised your case will review your dictated letters; that person will ensure that your written communication is clear and effective. The 'Review of Clinical Documents' form will be used to provide specific feedback to you about your reports.

4. In some ways, this rotation is like a graduate-level course.

There is a handbook that will be loaned to you for the month, with opportunities to read about the wide range of issues and problems addressed in DBP. You will be discussing these topics with the DBP 2nd and 3rd year fellows on a weekly basis.

We expect that you will record written reflection concerning your preschool training experience and that you will prepare a learning portfolio that compiles this and other items for faculty review before the end of the rotation.

You will present a tutorial focused on a DBP topic of your own choosing to DBP faculty and staff. Typically, you will present this tutorial to the group that attends the Tuesday afternoon DBP Clinical Case Conference. Our experience is that the resident tutorial is a rotation highlight. Past resident tutorials can be found on this website.

1. Review your individual schedule.

You are responsible for attending all scheduled meetings.

It should include any special scheduling requests that you have sent in before the rotation.

2. Complete NIRS form.

Please complete the National Information and Reporting System (NIRS) form, paying particular attention to the items highlighted in yellow, and return by email at the start of the rotation to Laura von Kampen (lvonkamp@stanford.edu). This information is required by the Maternal and Child Health Bureau, which supports our DBP training program.

3. Get approval for all proposed schedule changes that arise during the rotation.

Submit schedule change requests to the Chiefs’ office for approval

After Chiefs approve request, send schedule change to Laura von Kampen  (lvonkamp@stanford.edu); she will forward to rotation director for approval.

1. Prepare for your role in clinic.

Review learning objectives for each clinic; read any suggested chapters or articles.

2. At clinic, check in with clinic coordinator.

Check with the clinic coordinator at the start of clinic to find out which patients you are seeing.

You may be asked to lead the medical evaluation. This includes taking the full history, completing a full exam, and completing the dictation. If you lead a new consult, you will be supervised by an attending physician and will receive feedback

3. After clinic, complete clinic-related work.

If the child had a specific condition -- medical, developmental, or behavioral -- read about that condition.

If you led a clinic visit, ask the attending to fill out a DBP Clinical Skills: Resident Feedback Form (at least one completed form should be included in learning portfolio).

If you are writing a report, use the patient chart in the clinic workroom or retrieve the chart from the DBP administrative offices after clinic. Do not carry away from clinic any pieces of paper with patient protected health information.

If you wrote a report, ask the attending to fill out a DBP Patient Reports: Resident Feedback Form (at least one completed form should be included in learning portfolio).

4. Contact Laura von Kampen (lvonkamp@stanford.edu) and the clinic if you will be late for or cannot make a site visit due to emergency.

Find online contact information for each clinic under ‘Contacts’. Let the clinic know that you will not attend the site visit.

1. Before site visit, prepare for your role.

Review learning objectives for each site; read any suggested chapters or articles.

2. Notice that your role is active participant in some sites and an observer at other sites

Rarely, there is confusion about the visit schedule. If this happens when you arrive at the site, handle it graciously. Some residents have found that calling the contact person at each site in advance reminds them to expect you.

3. Contact Laura von Kampen (lvonkamp@stanford.edu) and the site if you will be late for or cannot make a site visit due to emergency.

Find online contact information for each site preceptor under ‘Contacts’. Let the site know that you will not attend the site visit.

1. Read any assigned chapters and articles for each tutorial (see DBP Tutorial learning objectives)

Contact Laura von Kampen (lvonkampen@stanford.edu) and the tutorial lead if you will be late for or cannot make the tutorial due to emergency.

Find online contact information for each tutorial lead under ‘Contacts’. Let the tutorial lead know that you will not attend the tutorial.

1. Review the instructions for completion and submission of your learning portfolio items.

All portfolio items are due at least 48 hours before your End-of-Rotation meeting with Dr. Huffman (or other designated faculty). The portfolio items should be sent to Dr. Huffman (or other designated faculty) as email attachments.

If you have any questions or issues, contact:

Lynne C. Huffman, MD, DBP Rotation Director 
Division of Developmental-Behavioral Pediatrics
Stanford University School of Medicine 
MSOB, 1265 Welch Road, Room X109-C, Stanford, CA 94305
V: 650-736-4744 
F: 650-721-5751
E: lynne.huffman@stanford.edu

Laura von Kampen, DBP Rotation Administrative Support 
Division of Developmental-Behavioral Pediatrics
Stanford University School of Medicine 
MSOB, 1265 Welch Road, Room X1C11, Stanford, CA 94305
V: 650-736-8914
F: 650-721-5751
E: lvonkamp@stanford.edu