The OHSU Neonatal-Perinatal Medicine Fellowship Program educational curriculum is robust and based on an in-depth knowledge of the science and literature underpinning neonatology. The experience is learner-centered; the fellows have an active role in shaping the design and implementation each year through continuous feedback. Through a competency-based, needs driven curriculum, we utilize didactic teaching, experiential learning, and simulation-based training to achieve the learning objectives set forth by the American Board of Pediatrics for NPM fellowship training.
Human Investigations Program (HIP)
The Human Investigations Program (HIP) is a unique and highly valuable resource for fellowship trainees at OHSU, and is supported by an NIH K30 grant. The HIP is a formal, expertly-taught two-year graduate program that fulfills all American Board of Pediatrics criteria for education in epidemiology and biostatisitics, as well as courses in research design, proposal development, and the integration of principles in molecular and cell biology, new pharmacology techniques, genomics and medical informatics into modern clinical, translational, and basic science research. The primary objective of HIP is to increase the competency of physician-scholars in the investigative process, and the coursework is directed toward young investigators and fellows. Our fellows typically participate in the Certificate for Human Investigations Program, although other participation is also a possibility.
The OHSU NPM Fellowship faculty takes bedside and informal teaching to be an incredibly important component of a scholarly experience. One-on-one and small group teaching forms a core of the fellowship, and offers real-world learning opportunities that are irreplaceable.
There are many educational conferences that are geared toward fellow education. Some are specific for only fellows, while others are inclusive of faculty and other interprofessionals.
Fellowship Core Curriculum
The core curriculum takes place on Tuesday and Wednesday mornings from 8 to 9am. Content is organized by organ system, is driven by objectives outlined by the American Board of Pediatrics, and is completed over the three years of training.The sessions are taught by faculty and fellows both within and outside of the division. There is a focus on neonatal physiology, evidence-based medicine, seminal papers in neonatology, as well as discussion of board questions. This is a dialectic educational experience that incorporates readings from a neonatal text, seminal papers, and board review questions. A key set of lectures are repeated every summer in order to help on board the new fellows. The core curriculum at OHSU integrates two key subtopics designed especially by faculty within the division to help to create a well-rounded experience for our fellows:
- Ethics Curriculum – designed by Dr. Gievers to help augment the clinical experience and best prepare fellows of how to approach challenging ethical situations.
- Quality Improvement/Patient Safety – designed by an inter-professional group, this 3 year longitudinal curriculum integrates active participation with didactics and self-directed learning through the Institute of Healthcare Improvement Open School. Additional opportunities are available for those fellows interested in QI/PS as their primary form of scholarship.
A joint quarterly conference between the Divisions of Neonatology and Maternal-Fetal Medicine involving didactic and dialect learning sessions, as well as discussions of perinatal cases, including clinical and management plans for upcoming deliveries.
Fetal therapy conference
Fetal therapy conference is a high-yield multidisciplinary conference held weekly. The conference brings together a multidisciplinary team of caregivers dedicated to developing comprehensive care plans for complex fetuses and their families. In this meeting, neonatologists, cardiologists, pediatrics surgeons, pediatric urologists, cardiothoracic surgeons, maternal-fetal medicine specialists, and radiologists review complex fetal cases, analyze ultrasounds, echocardiograms and MRIs to determine optimal management strategies.
Evidence-based journal club
Neonatologists must develop an ability to rapidly find, evaluate, and digest published reports to practice life-long evidence-based medicine. The monthly Journal Club is a venue for the presentation and in-depth analysis of classic, must-read papers interweaved with recent or current journal articles that challenge current clinical practice or scientific knowledge. Fellows and faculty learn the essentials of critical literature appraisal, identify strengths and weakness of the data, and interpret the meaning of the results as applied to their practice.
Critical care core physiology series
This physiology seminar, conducted in conjunction with the Divisions of Pediatric Critical Care, Cardiology, and Emergency Medicine, occurs monthly and reviews in detail essentials of physiology relevant to critical care.
Clinical consensus guidelines
Clinical Consensus Conference occurs biweekly, and contributes to the core of the quality improvement (QI) experience for fellows. Fellows, faculty, advanced practice providers, nursing, and other support professionals formulate practice changes and guidelines based on the latest evidence-based literature, with input from participants. Fellowship scholars are integrated into the process and expected to participate in some of these efforts, and to contribute to all aspects of the process.
Morbidity and mortality conference
A monthly quality review of morbidity and mortality cases from our practice to identify systems and/or practice issues in need of improvement or of particular educational value. Integrated into these sessions include teaching from the pathologist.
Research in progress (RIP)
RIP is held monthly and is dedicated to reviewing current research progress, both within and outside of the Division of Neonatology. The series is designed to expose fellows to research at OHSU as well as to provide a venue for the presentation of their individual work as it progresses through their fellowship.
This meeting is focused on systems issues within the division, and while serving to conduct ongoing division business, serves to introduce fellows to the systems that underlie the practice of medicine.
Cardiology morbidity and mortality conference
A monthly conference to discuss management of neonates and pediatric patients with congenital heart disease and cardiac issues;this is a formal and productive review of difficult cardiac cases.
Oregon perinatal-neonatal network webinar
A bimonthly conference where expert clinicians and researchers from the majority of Level III/IV NICUs in the states of Oregon and Southwest Washington present current hot topics, collaborative quality improvement work, and controversies in neonatology in a regional forum.
Simulation is part of the core experience for NPM Trainees at OHSU. Every summer, the first year fellows (and sometimes additional years) participate in a simulation boot camp that is run through a joined effort by NPM programs at OHSU, University of Washington, and British Columbia Women's Hospital &Health Centre. The boot camp rotates between the 3 sites. In addition, simulations are conducted with fellow, faculty, transport team, and nursing leadership. OHSU houses a 20,000 square foot simulation center where a majority of such activities take place. The fellows also have the opportunity to become a Neonatal Resuscitation Program (NRP) Instructor as part of their training. Finally, the fellows use simulation to teach the residents rotating through the NICU as part of their core experience.
It is often said, if you really know the material, you can teach it. We take teaching seriously in the Division of NPM at OHSU.
As medical educators we are responsible for creating transformative learning experiences; we should be held accountable for the outcomes of our interventions. The effectiveness of our instruction in neonatology will impact human life; therefore the methodology must be grounded in germane educational theory and evidence-based strategies.
We aim to produce fellows who are adept in the most effective instructional strategies for improving individual and team performance. In the NICU, our fellows participate in didactic teaching on rounds with residents and medical students, teach and supervise various technical skills (intubation, umbilical catheter insertion, etc), and they set up and give their own lecture once a week to pediatric and family practice residents rotating through the NICU.
The NPM fellows at OHSU undergo training and become certified as simulation-based Neonatal Resuscitation Program instructors where they hone their skills with multidisciplinary learners. Fellows develop competency-based curricula in procedural skill acquisition and use expert modeling for behavioral skill development.
For more information, please contact the program coordinator at 503-494-1077.