Educational Experience
Fellows on inpatient rotation
Throughout the training program the fellow attends and helps (with faculty supervision) direct daily bedside teaching- and work-rounds and patient care decisions while on clinical service. At the Los Angeles General Medical Center site, he/she attends weekly fellows’ conferences where topics are prepared and presented by the faculty, visiting guest speakers or the fellows themselves. The fellows also attend the morning case conferences two times a week (Monday and Wednesday), where they present clinical cases and their management for review by faculty and for academic and research-associated discourse. The fellows also participate in monthly journal club meetings; weekly neonatal-perinatal statistics rounds and high risk Obstetrics conferences; bioethics and discharge planning conferences. Third year fellows also participate in pretending attending rotations taking on supervised faculty responsibilities in all units. At children’s Hospital Los Angeles NICU fellows additionally actively participate in Pediatric surgery rounds, CT surgery rounds, pulmonary and or neurocritical care rounds. Program Director Lecture Series (PDLEC) occurs once a month where Program Director or a Faculty presents up to date information on current topics of interest in neonatology.
Core curriculum and board review series
All Fellows attend the weekly Core Curriculum lecture series on Thursdays (2:30 – 4:00 PM). Series is typically taught by variety of Neonatology as well as subspecialty faculty at Los Angeles General Medical Center and Children’s Hospital of Los Angeles. The core curriculum emphasizes specifically reviewing contents specifications for Neonatal Perinatal medicine sub-board of American Board of pediatrics in an interactive fashion. Board review series is driven by fellows active participation with faculty supervision conducted twice a month before core curriculum.
NRP and Simulation Program
Neonatal Resuscitation Program (NRP) and neonatal simulation training programs are conducted regularly at both the Children’s Hospital of Los Angeles as well as Los Angeles General Medical Center sites of our program. Both facilities are equipped with state of the art high fidelity and low fidelity simulators as well as task trainers. SimNewB, a high fidelity mannequin used at both sites provides interactive experience with hands on training including various procedures performed during neonatal resuscitation. In addition task trainers are utilized with an emphasis on enhancing individual procedural skills of the fellows in a simulation setting.
The principal components of our simulation training program offered to Neonatal Perinatal Medicine fellows include NRP provider courses, NRP instructor courses, boot camp training, mock codes, and Skills labs. In addition interested fellows have ample opportunities to actively participate as instructors in the simulation training for pediatric residents, nurses and other staff members. Fellows are also encouraged to join the faculty performing innovative research related to the simulation activities and outreach programs. At the Children’s Hospital of Los Angeles, the neonatal simulation program is an integral part of Las Madrinas Pediatric Simulation Research Laboratory. The laboratory also provides training and education for all pediatric subspecialties including PALS courses, ECMO simulation and various other competencies.
STABLE Course
The S.T.A.B.L.E. Program™ focuses on sick newborn care management in the gap between post-resuscitation in the delivery room and pre-transport (to a higher level of care). Six interactive learning modules comprise the S.T.A.B.L.E. Program™:
- Sugar and Safe Care: fluid management and glycemic control
- Temperature: methods to maintain the neutral thermal environment and minimal metabolic expense
- Airway: anatomical and artificial airway maintenance, ventilation, and blood gas analysis
- Blood Pressure: assessment and support of blood volume and circulation
- Laboratory Work: hematology, chemistries and septic work-up studies
- Emotional Support and Quality Improvement: support of the new parents and their families along with the legalities of interfacility transport and hospital admission to the NICU
S.T.A.B.L.E. Program™ Instructors at Los Angeles General Medical Center include attending neonatologists, neonatal nurse practitioners, registered nurses, and respiratory care practitioners. Students in the program are neonatal perinatal medicine fellows as well as faculty, nurses, respiratory therapists and emergency medical first responders. Certification in the S.T.A.B.L.E. Program™ lasts for two years. Keck School of Medicine provides this S.T.A.B.L.E. Program™ annually for all interested care providers at Los Angeles General Medical Center and Children’s Hospital Los Angeles.
Along with Neonatal Resuscitation Provider™ training, the American Academy of Pediatrics and the March of Dimes endorse the S.T.A.B.L.E. Program™ for all care team providers in the delivery room and nursery.
Ultrasound Course
Head ultrasound scans are an integral part of the care of sick newborn infants. This is the imaging mode of first choice because of ease of access. Sequential scans are now standard, and the results are used to assist in diagnosis (e.g. hypoxic ischemic encephalopathy, stroke), to aid decision making in possible withdrawal of intensive care and monitor complications and interventions (e.g. ventriculo-peritoneal shunt).
The course focuses on the identification of normal anatomical landmarks of the newborn brain as well as recognition and interpretation of common abnormal findings on ultrasound. It includes series of didactic lectures and hands on experience involving ultrasonography techniques with neonatal sonographer as well as Doppler use. The course is a part of elective radiology rotation offered at Los Angeles General Medical Center.
Objectives of the course
- Identify the indications for cranial ultrasound examination
- Interpret and differentiate normal as well as abnormal cranial ultrasound findings
- Apprehend the factors that influence the prognosis and long term outcomes of head ultrasound findings
- Understand the limitations and prognostic value of ultrasound findings
- Develop expertise with obtaining evidence based medical information and review literature pertinent to central nervous system
Training for point-of-care ultrasound for Lung, abdomen, spine and other areas is also available for interested fellows.
Other Courses for fellows
In addition, the fellows attend specific courses on research design and protocols and the writing of research papers during their training. Each fellow has to attend the week-long intensive ECMO Course as well as PICC line course at the Children’s Hospital Los Angeles site at least once during fellowship. All fellows attend functional echocardiology course during their first year of fellowship.
Other educational activities
Mortality and Morbidity Conferences
Combined Surgery/NICU Fellow conferences
Monthly newborn multi-disciplinary conference
Fellow as Teacher lectures
Neonatal ECMO Conference
Neonatal Pulmonary conference
Neonatal clinical consensus Meeting