ORIENTATION TO ROTATION

Welcome to Developmental-Behavioral Pediatrics (DBP)! We're glad to have you with us this month.

Your rotation will consist of many activities designed to provide you with a broad-based, well-rounded exposure to the subspecialties of Developmental-Behavioral Pediatrics and Neurodevelopmental Disabilities   The rotation is also designed to meet the goals laid out by the Academic Pediatric Association's Standard Rotation in DBP. 

Up to 27% of the content on your General Pediatrics Certification Board Examination, based on the Standard Rotation recommendations focuses on DBP in the following 6 areas:

• Preventive Pediatrics/Well Child Care (general behavior & development) (8%)
• Fetal and Neonatal Care (5%)
• Genetics, Dysmorphology, and Metabolic Disorders (3%)
• Mental and Behavioral Health (5%)
• Child Abuse and Neglect (4%)
• Psychosocial Issues (2%)

Many of your scheduled activities will take place at clinics located at Seattle Children's or at the UW Center on Human Development and Disability (CHDD). Other activities may include participation at community clinics or going on field trips.

Your schedule may be updated periodically over the month, as changes in our clinics and activities, your continuity clinics, or other unforeseen changes, are not uncommon. Please be sure to notify Dr. Zinner immediately of any changes, and also be sure to check the schedule on this website daily for any changes. 

Please ask questions, provide us with your feedback, and let us know what we can do to make your rotation rewarding and useful to you.

Developmental and Behavioral Pediatrics encompasses social, psychological, medical/health, and educational factors of all children, youth, and their families in the context of inborn and dynamic environmental influences.  In 2002, the American Board of Pediatrics officially recognized Developmental/Behavioral Pediatrics as a Board-certified subspecialty. 

One in 5 US families has a child or youth with a "special healthcare need".  Further, behavior and development are relevant to all children.  Despite this relevance, most pediatricians feel ill-equipped to identify and manage developmental and behavioral needs of their patients/families.  You as the pediatrician Medical Home provider will be among the most pivotal and continuous folks responsible to the infant/child/adolescent and caregivers for following child development and behavior needs; identifying special needs; shepherding families toward more specialized services; serving as an advocate for families; and other roles.  Although developmental/behavioral pediatricians can assist you in your primary role as the general pediatrician,  the ball will still primarily be in your court to take the lead for the vast majority of your patients with special needs, and for all your patients in general. 

Because your role as general pediatrician is so singularly influential, you spend one dedicated month during your pediatric residency training in developmental/behavioral pediatrics at all accredited U.S. pediatric residency training programs. 

We have designed your month to prepare you to meet this challenge in an exciting and exploratory way.  The outcome of your monthlong training will leave you with the tools and strategies you'll need to identify, manage and support your clients and their families confidently. You'll learn to become a more effective Medical Home provider during your month with us.  Focus will be placed on general development/behavior and on special needs.

In addition, this website has been created for you as an aid throughout your residency training as you manage the developmental and behavioral needs of your clients in your outpatient continuity clinic, subspecialty rotations, in the emergency department, and on inpatient services.

Thing One: Complete the Trainee Registration Form:

• Email Charise Espiritu right now! and write "I CONFIRM" in Subject Line to confirm you've completed the Trainee Registration Form
• Questions?  Nan Ringera or Richard Masse

Thing Two: What to do if you're unable to attend a scheduled activity:

• Email or phone BOTH the listed contact person and Dr. Sam Zinner immediately, before the scheduled activity (or as soon as possible) if you find that you are unable to attend a scheduled activity. Contact information for every activity can be found from this website's Home Page on the "Clinics and Activities" link for every activity.

Thing Three: Dictation Code (residents only)
If you do not know your UW Transcription Number (the same number used at the Roosevelt Clinic if your continuity clinic takes place there), contact right away either Scott Olson, 987-2525 or Kashena Konecki, 987-1834 or Lauree Herrmann, 987-2007, or simply email pedsresteam@seattlechildrens.org. Dictation instructions vary among different facilities. At the UW, you will need this Dictation Code.  Please see the "Clinics and Activities" link on the Home Page for specific dictation instructions for any particular clinic (when applicable), or talk with your Attending supervisor.  Complete your dictations promptly (Department's minimum standards for completion)

Thing Four: Prepare for each day's assignment
Each Clinic or Activity has its own webpage link, with Goals and Objectives. Read beforehand to avoid any missed expectations that day.

Complete Page 1 of the Trainee Exit Form.  We cannot qualify your completion of this rotation until we have received your completed form at the conclusion of your rotation.  Submit the completed Page 1 to Nan Ringera or in person at the CHDD room CD422.

Please look at the International Classification of Functioning, Disability and Health (ICF) Beginner's Guide early in the rotation.  The ICF is part of the World Health Organization's framework for health and disability.  The main point of ICF is to stress health and functioning, not disability.  The ICF is becoming the world standard for disability data, and the US will join nations around the world as ICF standards are incorporated into health laws.

Please also watch What is a DBP physician?, a35-minute video describing the activities of DBP physician, featuring Jan McGonagle, MD.

Your schedule changes weekly (somewhat) and the schedule can change at a moment's notice, so check the Schedule daily to determine your assignment. We will do our best to email you whenever there is a schedule change, but it is your responsibility to confirm your activity daily by checking the schedule posted on this website. 

All your scheduled activities have their own Goals and Ojectives, readings, and preparation materials.  So, check the Clinics and Activities one day before each activity! Also, the Clinical Observation Guide is available in the Clinics and Activities section, and may be used at your discretion at any clinic to help you identify and reinforce consistent clinical interviewing skills.

The Residency Review Committee (RRC) of the Accreditation Council for Graduate Medical Education requires pediatrics residents to complete a minimum 1-month block rotation in behavioral/developmental pediatrics (page 29).  While 1 month is very brief, we hope that you'll build a solid foundation in Developmental-Behavioral Pediatrics to enable you to serve the families in your care effectively and with confidence.  A variety of tools and resources are available to you on this website to help you meet these responsibilities during residency and beyond.  Please take the time periodically this month to familiarize yourself with these items.

Scheduled Time:
Preview the Clinics and Activities information for each of your scheduled clinics and activities prior to the scheduled date of your participation, including each of your assignment's Goals and Objectives. Arrive on time and prepared. If you are unable to arrive on time, or to arrive at all, contact Dr. Zinner immediately. In addition, contact the clinic or activity coordinator for your activity to inform that person of your situation (contact info at Clinics and Activities link).

Self-Guided Learning:
This time has been set aside for you to pace yourself, and select among the following options:

• Reading Assignments weeks 1 - 4 available on the website under "Readings and Professional Resources" (you'll need a User Name and Password from Dr. Zinner).
• Beginner's Guide of the World Health Organization ICF
• Readings and Professional Resources includes non-assigned articles of interest (you'll need a User Name and Password from Dr. Zinner).
• Self-training modules (online) available from this website's Home Page
• LEND Core Seminars (online)
  
• PREP Q&A for Developmental/Behavioral Pediatrics are available from Dr. Zinner

You will be registered on an email listserv of physicians and allied health professions, receiving once or twice monthly a summary of an article from a popular news media source that focuses on something relevant to Developmental-Behavioral Pediatrics.   In addition, the email will provide commentary and related clinical resources resources.  You may be responsible for preparing one version during your rotation. If so: Instructions are on this website under "Clinics & Activities" page. Do not this page with the In The News link from the Home Page (as this is simply a repository of prior stories, and provides no instructions to you).

• ARMEN, Angela, MD 987-3421
• BJORNSON, Kristie, PT, PhD 884-2066
• BREI, Timothy "Tim", MD 987-3748
  
• CROSTA, Quinn, ARNP 987-2917
• DOHERTY, Daniel "Dan", MD, PhD 685-1242
• HERZIG, Lisa, MD  987-1185
• KAUKL, Beth, ARNP 987-5069
• KING, Darcy, ARNP 987-2156
• LEAVITT, Anne, MD 685-7820
• LIVINGSTONE, DeAnna "Sue", MD 598-3986
• MILLER, Bob, DO
  
• MITZEL, Julia, ARNP 987-4780
• MYERS, Emily, MD 987-7094
• WALKER, William "Bill", MD - Division Director 987-3636
• ZINNER, Samuel "Sam", MD 987-0285

• CHOOEY, Jonathan (Captain) Madigan fellow
• GOTTESMAN, Marnina 987-6209 SCH fellow
• MATTSON, Julia 987-3195 SCH fellow
  
• PATTERSON, Paul (Major) Madigan fellow
• PERKINS, Elizabeth (Captain) Madigan fellow
• PHELPS NISHIGUCHI, ErikaSCH fellow
• SCOTT, Matthew (Captain) Madigan fellow
• SRINIVASAN, Anisha  987-3196 SCH fellow

Many other staff will help you throughout the month. Information regarding each of the clinical and other activities, and the staff involved, is available on the link Clinics and Activities, accessed through the Home Page.

For scheduling concerns, please be sure to contact: 

• Charice Espiritu charise.espiritu@seattlechildrens.org or (206) 987-2590 
• Dr. Sam Zinner samuel.zinner@seattlechildrens.org  (206) 987-0285
• Dr. Emily Myers emily.myers@seattlechildrens.org   (206) 987-7094

There is no free parking (or free lunches) available at CHDD/UWMC. You will generally be at the CHDD on Mondays, Wednesdays and some Fridays. There is no fee for parking at any of the outside clinical activities to which you will be assigned. Transportation options include biking, public bus services, as well as automobile. There is a shuttle that runs every 40 minutes between Seattle Children's and the UWMC. Parking information is available through Commuter Services [TEL: 685-1543]. You will need to bring your UW ID card and vehicle license plate number to purchase parking stubs.

Bikes at UW/CHDD
There is no designated bicycle path around the CHDD. However, there is a temporary walkway at the north side of the Experimental Education Unit (EEU), which is the 1-story school to the immediate east of the CHDD building.

For directions to clinics, please see Clinics and Activities.

The lunchroom at the CHDD is located in room CD174, on the first floor. The refrigerator, sink, and microwave are at your disposal. There are also vending machines, tables and chairs. The "Plaza Cafe" is located right across the street from the CHDD, in the main hospital, and the South Center is just to the west of the CHDD, and has a Subway outlet.

Do not leave wallets, purses or other valuables lying around. Keep these on your person, and not at your desk!!

At the CHDD, you will have a desk to share in room CD243. In addition, the common workroom in CD221 is available for dictation. On Tuesdays at the Neurodevelopmental Clinic at Seattle Children's, the common work room on 6W is all there is!! Other clinics will orient you to their work space.