HAB Manual 2019
HAB Manual 2019
HAB Manual 2019
BASIC
AND
QUALITY STANDARDS
OF THE PEDIATRIC RESIDENCY PROGRAM
TABLE OF CONTENTS
Section One: Basic and Quality Standards of the Pediatric Residency Program
1. Foreword
Preface
6. Evaluation Instruments
6.1 Vision-Mission
6.2 Training Program
6.3 Trainees
6.4 Consultants
6.5 Administration
6.6 Patient Service & Facilities
6.7 Research
6.8 Community Involvement
7. Appendices
7.1 Appendix 1 – PPS HAB Visitation Guide
7.2 Appendix 2 – Summary of Rotation
7.3 Appendix 3 – PPS Minimum Equipment Requirements
7.4 Appendix 4 – PPS Required Textbooks and Journals
7.5 Appendix 5 – PPS Neonatal Level Unit Capabilities/Requirements
7.6 Appendix 6 - PPS Critical Care Unit Capabilities/Requirements
7.7 Appendix 7 – List of Documents to be Submitted by Hospital Applying for
Accreditation or Reaccreditation
7.8 Appendix 8 – PPS Summary Report Form
7.9 Appendix 9 – PPS Statistical Rating (Accreditors’ Form)
7.10 Appendix 10 - PPS Statistical Rating (Self-Assessment Form)
The Philippine Pediatric Society Inc. Hospital Accreditation Board (HAB) has revised the 2013
HAB Accreditation and Training Manual and changed the Competency Based to Outcome
Based Education Curriculum.
Modern medical education and higher education training has taken the trend of moving
towards demonstration of “intended or desirable outcomes”. An “outcome” refers to high
quality culminating observable demonstration of significant learning that occurs after a set
of learning experiences. Through the years, its meaning has evolved from one that
emphasizes knowledge through concepts, theories and methodologies (content based) to
one that integrates knowledge, skills and attitude into an attribute called “competency”
(competency based) to one that demands that competency be performed in real world
situations judged using authentic assessment tools (outcomes based).
The Philippine medical education system which largely serves as the foundation of offshoot
clinical training programs like internship, residency and even fellowship must make the shift
to outcome based teaching-learning models because of the following reasons: (1) it focuses
on outcomes enabling our current higher education systems to address concerns on
accountability and effectively pairs legislative control with institutional autonomy; (2) it lays
down intended learning outcomes of an institution and commits its educational resources
until goals are achieved; (3) it is the benchmarking concept in higher education and training
and; (4) it aims to organize a work-integrated education at the program level.
It is about time the PPS reorients its training program to that which is “trainee centered,
clear, designed with the end in mind, expanded with numerous opportunities for consistent
achievement of success”. The shift from a training syllabus to a training learning program,
from mostly summative to more frequent formative assessments is all constructively aligned
horizontally and vertically.
The PPS sincerely wishes that our training institutions and their deeply committed
pediatrician-mentors find genuine use and productivity in the utilization of this document.
SALVACION R. GATCHALIAN, MD
President
Philippine Pediatric Society, Inc.
PREFACE
There is a need to continuously revisit, review and revise the existing standards
on the implementation and evaluation of the training programs in accordance
with the directive of the Commission on Higher Education (CHED) using the
World Federation of Medical Education (WFME) framework for Postgraduate
Medical Education.
The HAB and its members and the Committee on Curriculum reviewed and
revised the 2013 Accreditation and Curriculum Manual of Pediatric Residency
Training. We have added another Accreditation Area, that of TRAINEES, hence
there are now a total of eight (8) evaluation areas. We have improved the self-
assessment instruments to make it relevant and effective. Likewise, weight
values of the different evaluation areas and the computation instruments were
revised.
I encourage all PPS-HAB accredited hospitals to use this revised Manual to guide
them in their mission to come up with the best training program they can offer
their trainees.
MELINDA M. ATIENZA, MD
Secretary
Hospital Accreditation Board
OFFICERS AND MEMBERS OF BOARD OF TRUSTEES
President Salvacion R. Gatchalian, MD
Vice President Joselyn A. Eusebio, MD
Secretary Florentina U. Ty, MD
Assistant Secretary Francisco E. Anacleto, Jr., MD
Treasurer Cesar M. Ong, MD
Assistant Treasurer Edwin V. Rodriguez, MD
Past President Alexander O. Tuazon, MD
Members
Marvin C. Callanta, MD Michael T. Resurreccion, MD
Francis M. Dimalanta, MD Wilfredo R. Santos, MD
Anna Lisa T. Ong-Lim, MD Evelyn L. Siasu, MD
Ma. Stella G. Paspe, MD
EDITORIAL BOARD
Xerxes R. Navarro, MD
Carmelo A. Alfiler, MD
Melinda M. Atienza, MD
THE PHILIPPINE PEDIATRIC SOCIETY HOSPITAL ACCREDITATION BOARD (HAB)
1. Composition: The members of the Hospital Accreditation Board (HAB) shall be sixteen (16)
Fellows of the Philippine Pediatric Society who have been in good standing for at least the five
preceding (5) years.
1.1 President – as Chair
1.2 Vice President - as Co-chair
1.3 Immediate Past President
1.4 The HAB Secretary, a voting member, is a Fellow appointed by the President and
approved by the BOT with a term of two (2) years.
1.5 The following members shall be appointed by the President and approved by the BOT
1.5.1 Four (4) members from the Specialty Board
1.5.2 Four (4) Past Presidents
1.5.3 Four (4) appointees with a tenure of one (1) year each with an academic
rank of at least associate professor, past chair of accredited residency
training program, or past chapter president:
1.5.3.1 two (2) from Luzon
1.5.3.1.1 one (1) from the North of NCR
1.5.3.1.2 one (1) from the South of NCR
1.5.3.2 one (1) from the Visayas
1.5.3.3 one (1) from Mindanao
1.6 The Assistant Secretary of the BOT, a non-voting member assists the Board Secretary
1.7 When deemed necessary, the president shall appoint hospital accreditation deputies to
assist the HAB in site visits and evaluations. Deputies shall consist of Fellows who shall
meet any of the following requirements.
1.7.1 A past president
1.7.2 A previous member of HAB
1.7.3 A current or past chapter president
1.7.4 A current or past chair of a department of pediatrics with at least level II
accreditation.
2.1 Develop and regularly update the basic and quality standards of the HAB for Pediatric
Residency Training Programs.
2.2 Develop and regularly update the basic and quality standards of the Subspecialty
Fellowship Training Programs in coordination with the Council on Subspecialties and
Sections.
2.4 Recognize Subspecialty Fellowship Training Programs that are accredited by the
respective Subspecialty Societies and Sections
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2.5 Offer training seminars, workshops and lectures for Pediatric Teaching Consultants.
3. The HAB Fund shall consist of accreditation and WISE fees paid by institutions to PPS.
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GENERAL GUIDELINES FOR THE ACCREDITATION OF A
PEDIATRIC RESIDENCY PROGRAM
1. The PPS-HAB Accreditation
1.1 The PPS Accreditation is a status granted to a pediatric residency program as recognition
that it has met the standards of quality and excellence set by the Hospital Accreditation
Board.
1.2 It is founded on the concepts of self-regulation focused on evaluation and the continuing
improvement of educational quality and services.
2.1.1 This is an essential aspect of the PPS accreditation process. This is where the
department does a critical review and assessment of its organization and
program, and how these align with those of the PPS and the HAB. The self-
assessment is an analysis of the department’s educational resources and
effectiveness by its own consultants and residents. It demonstrates a
responsibility inherent in education and in the continuing development of a
department of pediatrics offering a postgraduate residency program. The
activities include a thorough self-examination based on the evaluation
instruments provided by the HAB.
2.1.2 Accreditation documents must be received by the HAB not later than six (6)
months before the expiration of the Program’s current accreditation
2.2.1 The Accreditation Team is composed of at least two members of the HAB
and/or deputies.
2.2.2 The primary task of the accrediting team is to validate claims and statements
in the self-assessment report and confirm alignment with the PPS and HAB
Standards through the following activities:
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2.2.2.6 Examination of exhibits, documents, publications, logbooks, minutes
of departmental meetings, manual of standard operating procedures
(SOP), development plan, research papers, etc.
2.3.1 The accrediting team submits a formal assessment of the accreditation visit
and the Summary Report Form to the HAB, to include recommendations for
improvement when deemed appropriate and necessary. (See Appendix 8 &
9)
2.3.2 The HAB evaluates the report and makes a decision on whether or not to
grant accreditation.
3. Areas to be evaluated
3.1 Vision-Mission
3.2 Training Program
3.3 Trainees
3.4 Consultants
3.5 Administration
3.6 Patient Services & Facilities
3.7 Research
3.8 Community Involvement
(see Appendix 1 – PPS HAB Visitation Guide)
4. Levels of Accreditation
For purposes of receiving benefits and progressive deregulation, Pediatric Residency Programs are
classified by the HAB in one of four (4) accredited levels.
4.1 Level I accredited/re-accredited status: Residency programs which have been granted
initial accreditation or re-accreditation effective for a period of three (3) years based on
the appraisal of the HAB. These programs have met the minimum requirements for a 3-
year residency program. They have also met the following additional criteria:
4.1.1 The Neonatal Unit is classified as Level II by the HAB, based on standards set
by the Philippine Society of Newborn Medicine.
4.1.2 The Pediatric Intensive Care Unit (PICU) is classified as level I PICU based on
the standards of the Society of Pediatric Critical Care Medicine Philippines
(SPCCMP)
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4.1.4 The department applying for initial accreditation must have been in existence
for at least one (1) year. Once the program starts, it is given five (5) years to
achieve the above (section 4.1.2) at which time it is expected that there will
be graduates of the program for the last three (3) years.
4.1.5 Twice weekly community service must be rendered by the trainees.
4.1.6 A Level I Program must meet the standards and be promoted to Level II
within 12 years of its commencement.
4.2 Level II re-accredited status: Residency programs which have been re-accredited
effective for a period of three (3) years based on the appraisal of the HAB. In addition to
the criteria in Level I, these programs have met the following additional criteria:
4.3 Level III re-accredited status: Residency programs which have been re-accredited
effective for a period of four (4) years based on the appraisal of the HAB. In addition to
the criteria in Level II, these programs must satisfy the first five (5) of the following
additional criteria (4.3.1 to 4.3.5), and at least one (1) of the remaining three (4.3.6 to
4.3.8):
4.3.2 The Neonatal Unit is classified as Level III by the HAB based on standards set
by the Philippine Society of Newborn Medicine.
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4.3.4 A highly creditable performance in the PPS specialty board certifying
examinations over the last four (4) years as determined by the HAB. All
graduates must take the examination within two (2) years and at least eighty
percent (80%) must pass.
4.4 Level IV re-accredited status: Residency programs which have been re-accredited
effective for a period of five (5) years based on the appraisal of the HAB. They are highly
respected as very high quality training programs in the Philippines and carry the prestige
and authority comparable to similar programs in excellent foreign medical centers. In
addition to the criteria in Level III, these programs must have met the following
additional criteria:
4.4.2 A Level III Neonatal Unit and a Level II Pediatric Intensive Care Unit carry
state-of-the-art equipment and facilities. (See Appendices 5 & 6)
4.4.4 Excellent outcomes in research as seen in the number, scope, and impact of
scholarly publications in refereed national and international journals.
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4.4.6 Excellent outcomes in the demonstration of the program’s social
accountability in teaching, service, and research using the WHO criteria of
relevance, quality, equity, and cost-effectiveness.
5. The accreditation report is subject to deliberation and the decision of the HAB is final.
2. Level II
2.1. Official recognition by PPS as accredited training program for three (3) years
2.2. The department is eligible to apply for a PPS research grant
2.3. Residency graduates may apply to take the written part (Part I) of the Specialty Board
Examinations and oral examination (Part II) after two (2) years of pediatric practice, subject
to the approval of the Specialty Board
2.4. The department may offer one scientific forum every two (2) years
3. Level - III
3.1. Official recognition by PPS as accredited training program for three (3) years
3.2. The department is eligible to apply for a PPS research grant.
3.3. The department is eligible to apply one general CME/scientific –forum course and one
subspecialty post-graduate course annually.
3.4. The Chief Resident may apply for written examination (Part I) immediately and oral
examination (Part II) after one (1) year of pediatric practice subject to the approval of the
Specialty Board.
3.5. The other residency graduates may apply for written Specialty Board examination (Part 1)
immediately and oral examination (Part II) after two (2) years of pediatric practice subject to
the approval of the Specialty Board.
4. Level - IV
4.1. Official recognition by PPS as accredited training program for five (5) years
4.2. The department is eligible to apply for several slots of PPS research grants.
4.3. The department is eligible to offer one general CME/postgraduate course and several
subspecialty CME courses annually.
4.4. The Chief Resident may take the written and oral (Part 1 & II) Specialty Board examinations
immediately subject to the approval of the Specialty Board.
4.5. The other residency graduates may apply for written examination (Part I) immediately and
oral examination (Part II) after one (1) year of pediatric practice subject to the approval of
the Specialty Board.
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GUIDELINES FOR GRANTING RE-ACCREDITATION
1. For any hospital to be accredited, the areas of Training Program, Trainees and Consultants must
have a rating of at least three (3) in all components. A rating of three (3) is considered good and
passing.
2. Progress Report
If only one (1) area other than the Training Program, Trainees and Consultants is rated below
three (3), the hospital is granted accreditation but is required to submit a progress report within
three (3) months except for community.
3. Interim Visit
If two (2) or three (3) areas other than the Training Program, Trainees and Consultants are rated
below three (3), an interim visit will be required within six (6) months. After two (2) interim visits
and there is no improvement, the Accreditation status will be downgraded.
4. Deferment
4.1. If one or two of the three (3) items in either the Training Program, Trainees or Consultants
is/are rated below three (3), the accreditation will be deferred.
4.2. If all the three (3) areas ---Training Program, Trainees and Consultants--- are rated below
three (3), the accreditation will be revoked. They may reapply after a year.
All other cases are subject to deliberations of the HAB. The decision of the HAB is final.
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THE SELF-ASSESSMENT PROCESS
1. Advantages of the Self-Assessment Process
1.1. It serves to point out the strengths of the department of pediatrics and its residency
program.
1.2. It helps to diagnose difficulties, weaknesses or gaps in the department of pediatrics and its
residency program, provides a basis for making decisions about needed improvements,
and assists in setting up priorities for such improvements.
1.3. It leads to the realization by all those involved that the department of pediatrics has many
component parts— administration, trainees, consultants, nursing and paramedical
personnel, a residency training program, services, research activities, resources and
facilities—each of which relates to or affects the others, so that decisions and revisions
affecting any one of component parts will affect, to varying degrees, some or all of the
parts.
1.4. It enables a department of pediatrics to see itself objectively.
1.5. It can assist the department of pediatrics in identifying new problems, opportunities and
threats in developing consensus or future departmental priorities in step with the times,
and in proposing strategies not yet included in other plans.
For first-time applicants, a letter must be sent to PPS HAB c/o the PPS President (see
above) citing the cogent need to offer a residency training program. Following due
deliberation, the Board either approves or denies such application. If approved, the new
applicant will be instructed to proceed with the Self-Assessment Process (STEP TWO).
2.2.1 The PPS HAB recommends that the entire department of pediatrics---administration,
consultant staff, trainees, nurses and paramedical personnel—participate in the
process.
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2.2.2 The department chair shall organize a Self-Assessment Committee or Staff
composed of a chair, vice-chair, secretary and two (2) members (consultant and
resident) for each area to be evaluated, namely:
a. Vision-Mission
b. Training Program
c. Trainees
d. Consultants
e. Administration
f. Patient Services/Facilities
g. Research
h. Community Involvement
2.2.3 The Self-Assessment Committee/ Staff will organize, plan and manage the
departmental self-assessment in all the areas.
2.2.4 The Self-Assessment Committee/ Staff secretary shall keep a record of all meetings
and accomplishments. These minutes should be available among the exhibits to be
viewed by the HAB accreditors during the formal visit.
2.3.1 The self- assessment exercise begins with the vision-mission. This must be
accomplished before the evaluation begins, since all other areas will be surveyed
in view of the vision-mission of the department. The consultant assigned to
evaluate the vision-mission should complete his/her work first and make a
presentation to the whole department assembled in a plenary session.
2.3.3 For the purposes of this self –assessment the following definitions may be
adopted. “VISION” refers to the long-term picture of what the department will be
in the future. It is a statement of being. A statement of the long-term aspirations
and dreams of the members of the departmental staff. On the other hand,
“MISSION” is a statement of doing. It is the department’s commitment. It is a
declaration of how to achieve the vision.
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2.3.5 Based on the vision-mission statement, write the goals and objectives for the
department’s key result areas. The vision-mission statement will also guide the
preparation of the long term and short-term development plan of the department
of pediatrics.
2.3.6 After the vision-mission has been accepted by the whole departmental consultants
and residents, the concerned personnel shall prepare the organizational charts, and
needed guides on departmental policies such as: Standard Operating Procedures
(SOP) for each pediatric area, job descriptions, department manual, handbooks,
etc.
2.4 STEP FOUR: Answer the eight (8) Evaluation Instruments and compute the ratings for
each of the eight (8) areas
2.4.1 Each Evaluation Instrument has a brief description which forms the basis for
evaluation. This describes the concept behind the criteria for each of the eight (8)
evaluation areas.
2.4.2 This is then followed by the main Evaluation Instrument. The Instrument consists
of a series of statements delineating traits, provisions, conditions or characteristics
found in good pediatric departments and its residency programs.
2.4.3 Evaluations represent the best judgment of those making the evaluation after all
the evidence has been considered. The following rating scale will be used:
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2.5 STEP FIVE: Prepare the appendices to the Self-Assessment Report and the exhibits for
the formal visit.
2.5.1 The preparation of the appendices should be done throughout the self-
assessment process. Appendices are evidences of the fulfillment of requirements.
These should form part of the Self-Assessment Report. The PPS-HAB secretariat
will provide a checklist of required appendices.
2.5.2 The exhibits required during the formal accreditation visit should also be prepared
throughout the Self-Assessment process. The PPS-HAB secretariat will provide a
checklist of required exhibits.
2.6 STEP SIX: For each of the eight (8) areas, describe the “ACTION TAKEN” on all
“RECOMMENDATIONS” during the last accreditation visit.
2.6.1 The “HAB Recommendations” should be listed on the left column and the
“ACTION” taken (implemented, partially implemented, not implemented) should
be described on the right column as follows:
2.7 STEP SEVEN: For each of the eight (8) areas, formulate the “BEST FEATURES”
(strengths of the area) and the “RECOMMENDATIONS” (weaknesses of the area).
The format is as follows:
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2.9 STEP NINE: All the eight (8) area reports are presented by the Self-Assessment
Committee/ staff to the departmental consultants and residents in a formal meeting.
2.9.1 A plenary meeting of all the departmental consultants, residents, nurses,
paramedical and administrative personnel should be called. The eight (8) area
reports are then presented by the consultants assigned.
2.9.2 Further corrections, additions, changes are given and taken in good spirit and are
integrated into the report.
2.9.3 The Self-Assessment Committee/ Staff resolve any conflict that may arise.
2.10 STEP TEN: Prepare the final Report of the Department’s Self-Assessment of the Pediatric
Residency Program. The Self-Assessment Committee/ Staff shall prepare the final report
for submission to the PPS Hospital Accreditation Board. The contents of the final report
are as follows:
2.10.6 The eight (8) area reports. Each area report shall include:
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3. Submission of the Departmental Self-Assessment of the Pediatric Residency Program
Two compiled copies of the Departmental Self-Assessment report along with other appendices
and requirements should be submitted to the PPS HAB Secretariat six (6) months prior to the
visit.
4. Conclusion: The self-assessment process serves as a great incentive for the self-improvement of
the department of pediatrics and its residency program. The prospect, however, of an
accreditation visit is an even more powerful incentive to self-improvement.
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BASIC AND QUALITY STANDARDS
FOR A PEDIATRIC RESIDENCY PROGRAM
1. GOAL
The Pediatric Residency Program shall provide the opportunity for the acquisition of knowledge,
skills and attitudes in the preventive, promotive and curative aspects of the practice of pediatrics
for Filipino children, their families and communities.
2. GENERAL OBJECTIVES
2.1 Provide the pediatric residents with the knowledge, skills and attitudes in consonance with
the concept of a general pediatrician.
2.2 Prepare pediatric residents for post-residency subspecialization, research, teaching and other
postgraduate studies (i.e., masters, doctoral courses).
2.3 Reaffirm the profound importance of the vital and long-standing role of pediatricians in
promoting the health and well-being of all children in the families and communities they
serve (community dimension of pediatric practice).
2.4 Promote the integration of existing public health services into the training of pediatric
residents.
2.5 Develop in pediatric residents habits and attitudes to practice their profession with
integrity and ethical conduct.
2.6 Develop in the pediatric residents the attitude of engaging in lifetime continuing pediatric
education responsive to changing needs and issues.
The graduates of a Pediatric Residency Program may assume any or all of the following roles:
3.1 Clinician
a. Given an emergency situation, the pediatrician, utilizing holistic approach and critical
thinking, shall recognize the emergency situation, identify the cause, and apply corrective
or definitive measures.
b. Given a non-emergency situation, the pediatrician, utilizing holistic approach and critical
thinking, shall arrive at a logical impression, plan and implement the therapy, provide
psychological support to the family, and emphasize preventive measures.
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3.2 Educator
a. Given a patient and his/her family in a clinical situation, the pediatrician, utilizing
holistic approach and critical thinking, shall determine their knowledge and attitude
about the clinical problem, address issues to be resolved, and institute the proper
health education strategies.
b. Given a population group in a community (i.e., barangay health workers, school staff,
parents, adolescents, and other groups), the pediatrician, utilizing holistic approach
and critical thinking, shall plan, implement, and evaluate the appropriate educational
activity.
3.3 Researcher
3.4 Leader/Manager
a. Given a pediatric health care facility in the community, the pediatrician, utilizing
holistic approach and critical thinking, shall plan, implement, and evaluate the
operations of the pediatric health care facility.
b. Given an area to start a pediatric project for families and communities, the
pediatrician, utilizing holistic approach and critical thinking, shall plan, implement,
and evaluate the project.
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3.5 Social Advocate
Given families or communities with pediatric issues of concern, the pediatrician, utilizing holistic
approach and critical thinking, shall:
4. LEARNING OUTCOMES
The Philippine Pediatric Society formulated its learning outcomes which are
congruent with the ten (10) learning outcomes of CHED but with an addition of
community – based practice.
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8. Professionalism Adherence to ethical and legal principles
Compliance to existing laws, rules and
regulations that govern the medical
profession
Compassionate responsibility and
accountability to patient welfare
9. Nationalism and internationalism Awareness of global health care challenges
Awareness of cultural and religious diversity
10. Social accountability Knowledge of the concept of social
accountability and its values
Knowledge of the priority health needs in
terms of pediatrics and the national
objectives for health of the nation
11. Community – oriented practice Awareness of important characteristics of
and needs of the community that might
impact on patient care
Applies the understanding of these features
to improve the management of the
patient’s population
Awareness of social determinants of health
Knowledge of resources available in the
community and effective use of these
resources
Knowledge of the principles of preventive
pediatric health care
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EVALUATION INSTRUMENTS
Area 1: VISION-MISSION-OBJECTIVES
MINIMUM BASIC STANDARDS
1. The vision-mission-objectives must be aligned with the vision-mission of the Philippine Pediatric
Society (PPS) and the hospital / institution.
5. The objectives of the training program must be aligned with the program outcomes set by the
PPS.
QUALITY STANDARDS
3. The objectives of the training program should address the development of habits and attitudes
necessary to practice the profession with integrity and ethical conduct.
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ANNOTATIONS
2. The department should determine its vision-mission in receiving resident trainees and offering
them instruction. It should be determined in the light of the stakeholders which it intends to
serve and the needs of the community in which it exists.
3. Based on the vision-mission statements, the goals and objectives for the department’s key result
areas should be written. It will guide the preparation of the long- and short-term development
plans of the department.
EVALUATION INSTRUMENT
The accreditors should use the vision-mission-objectives as guideposts in evaluating the different
areas of the department. Since these analysis statements are not weighted, their scores are not
included in the overall computation. The following symbols should be used:
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INSTRUCTIONS: Evaluate each statement using the scale provided. Write the assessment inside the
parenthesis. A numerical rating is NOT needed for this area.
( ) 6. The objectives of the residency program are aligned with the program outcomes set
by the PPS.
( ) 7. The objectives of the training program are clearly specified and attainable.
( ) 8. The objectives of the training program address the development of habits and
attitudes necessary to practice the profession with integrity and ethical conduct.
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AREA 2: TRAINING PROGRAM
MINIMUM BASIC STANDARDS
1. The department must have its own unique institutional formal written residency program
which shall include:
2. The minimum number of staff required for the opening of a residency program must be:
Three (3) core board certified pediatricians and three (3) trainees. The consultant to
trainee ratio should be at least 1:2.
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3.23. Behavioral disorders
3.24. Critical care
3.25. Emergency care
3.26. Poisoning
3.27. Sports medicine
3.28. Pharmacology
3.29. Environmental health
3.30. Ethical issues in pediatrics
3.31. Care of children with special needs
4. The curriculum content must also include the Common Acute, Complex and Chronic
Childhood Conditions.
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4.1.19. Allergic disorders: eczema, urticaria/angioedema/anaphylaxis
4.1.20. Common viral illnesses: measles, mumps, rubella, roseola infantum, erythema
infectious, varicella-zoster, Hepatitis A/B/C/D/E/G, rotavirus, rabies,
adenovirus, Norwalk agent, influenza, enteroviruses, RSV, cytomegalovirus,
herpes simplex, HIV, Epstein-Barr virus and arbovirus (H-fever).
4.1.21. Common bacterial infections: TB, diphtheria, tetanus, pertussis, pneumonia,
salmonella, staphylococcal aureus, N. gonorrhea, N. meningitides, shigellosis,
E. coli, Treponema pallidum, H. influenza type B, streptococcal group B and D,
campylobacter jejuni, yersinia enterocolitidis, chlamydia.
4.1.22. Fungal infection: candidiasis
4.1.23. Parasitic infections: Giardia lamblia, toxoplasma gondii, trichomonas, visceral
larva migrants, ascaris lumbricoides, enterobius vermicularis, E. histolytica,
plasmodium sp.
4.1.24. Colds: common colds, allergic rhinitis
4.1.25. Renal disorders: UTI, AGN, nephrotic syndrome
4.1.26. Genital disorders: undescended testes, retractile testes, hernia, hydrocele,
imperforate hymen, ovarian torsion and vulvovaginitis
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4.2.23. Pediatric poisoning
4.2.24. Animal bite
4.2.25. Short stature: growth hormone deficiency, failure to thrive, hypothyroidism,
malnutrition
4.2.26. Common bacterial causes of nosocomial infections: Klebsiella, enterobacter,
pseudomonas, CONS
4.2.27. Renal disorders: urolithiasis, renal TB, renal tubular acidosis, acute and
chronic renal failure
4.2.28. Hypertension: renal, vascular, endocrine and neuroblastoma
4.2.29. Collagen and vascular disorders: rheumatic diseases, SLE, JRA,
dermatomyositis, scleroderma, ankylosing spondylitis, post-infectious
arthritis, arthritis of IBD, Henoch-Schoenlein purpura and Takayasu arteritis.
4.2.30. Metabolic disorders: IEM
4.2.31. Endocrine disorders: adrenal disorders, disorders of gonads & puberty,
disorders of parathyroid
4.2.32. Musculo-skeletal disorders: developmental dysplasia of hip, skeletal
dysplasia, osteogenesis imperfecta, fractures, torticollis, Legg-Calve-Perthes
disease, Osgood-Schlatter disease
4.2.33. Skin disorders: Hemangiomas, Scabies, SSSS, Pediculosis, Molluscum
contagiosum, Steven-Johnson syndrome
5. The training rotation must be practice-based involving the personal participation of the
resident in the services and responsibilities of patient care in various settings. The sequence
of rotation must include:
Ward 6 months
OPD / ER 4 months
NICU 2 months
25 | P a g e
5.2. Second Year
Ward 4 months
OPD / ER 3 months
*Subspecialties / Electives 2 months [1 month subspecialty preferably PICU,
½ month research, ½ month radiology]
Community 1 month
NICU 2 months
Ward 3 months
OPD / ER 2 months
NICU 2 months
Subspecialties /Electives 4 months [1 month PICU, 2 months subspecialty of
choice, 1 month research]
Community/CPU 1 month
6. The learning activities must encompass integrated practical and theoretical instruction
(competency-based approach, problem-oriented strategies, evidence-based medicine, and
practice-based training including values formation, bioethics, and community orientation).
The learning activities should include:
6.1. Bedside rounds with the chair, training officer, or consultants
6.2. Supervised ER and OPD clinics
6.3. Supervised lectures/journal critic & appraisal/chart reviews
6.4. Clinical conferences
6.4.1. Case presentations (grand rounds, case discussions, diagnostic / management
conferences, and bioethics conferences)
6.4.2. Morbidity and mortality conferences
6.4.3. Endorsement conferences / rounds
6.5. Conferences with family members
26 | P a g e
6.6. Research workshops/presentations
6.7. Mentoring activities
7. The following pediatric procedures must be included in the technical skills training part of the
program:
27 | P a g e
8. The latest editions of the HAB-required textbooks, journals, and PPS publications outlined in
Appendix 3 must be available at the department’s library. (Appendix 4)
9. Each trainee must be certified by the PPS to have satisfactorily completed the following
courses:
9.1. Pediatric Resuscitation
9.2. Neonatal Resuscitation Program Plus
10. Formative evaluations must be done at regular intervals. The residents must take the WISE
yearly. A summative evaluation must be done at the end of each year level of training.
11. A variety of evaluation strategies must be used to evaluate clinical competence including:
11.1. Clinical conferences and oral reports
11.2. Written examinations
11.3. OSOE / OSCE
QUALITY STANDARDS
1. The objectives and content should be appropriate to the national and regional health needs
(leading causes of morbidity and mortality) and expectations / demands of the Filipino
population.
2. The department should have its own unique institutional formal written residency program
focused on primary care. There must be a well written instructional design in general
pediatrics and the subspecialties, according to year level, using the template provided in
Section 2.
3. The instructional design should address the different professional roles of a pediatrician: (a)
healthcare provider with emphasis on primary care, (b) health educator, (c) researcher, (d)
healthcare manager, and (e) social mobilizer.
1. The curriculum content should include the common acute, complex, and common chronic
childhood conditions.
28 | P a g e
C. Evaluation
1. The program should include a process of evaluation that measures clinical competence,
promote learning, and document adequacy of training, including the criteria for passing
assessments.
3. The trainees should receive regular constructive feedback about their performance.
4. The program should be evaluated and monitored regularly to ensure the attainment of
program outcomes and assess the progress of the trainees.
5. The results of program evaluation should be utilized to enhance and revise the curriculum.
D. Program Outcomes
1. All graduates during the accreditation period must take the SB examinations within two (2)
years of graduation.
2. Residency programs granted level I & II accreditation status must be reaccredited after three
(3) years, level III status after four (4) years and level IV after five (5) years.
3. The program should have a creditable performance in the PPS certifying examinations.
2.1. Level I – at least fifty percent (50%) must pass
2.2. Level II – at least sixty percent (60%) must pass
2.3. Level III – at least eighty percent (80%) must pass
2.4. Level IV – at least ninety percent (90%) must pass
29 | P a g e
d. Program evaluation
8. List of graduates in the past accreditation period with the results of their performances in the
PPS certifying examinations.
9. Yearly performance report on the WISE indicating the number of examinees per year level and
the percentage of successful examinees
EVALUATION INSTRUMENT
NA Not applicable
INSTRUCTIONS: Following the rating scale definition, write the assessment that best describes to
what extent the provisions of the standards are met inside the parenthesis.
( ) 1. The objectives and content are appropriate to the national and regional health needs,
and expectations / demands of the Filipino population.
( ) 2. There are well written instructional designs in general pediatrics and the
subspecialties according to year levels.
( ) 3.3. Researcher
( ) MEAN
30 | P a g e
( ) 1. The rotations follow the HAB recommendations outlined in Appendix 2.
( ) 3. The learning activities include the must-have activities recommended by the HAB:
3.1. Bedside rounds with the chair, training officer, or consultants
3.2. Supervised ER and OPD clinics
3.3. Supervised lectures and journal reviews
3.4. Clinical conferences
3.4.1. Case presentations (grand rounds, case discussions, diagnostic /
management conferences, and bioethics conferences)
3.4.2. Morbidity and mortality conferences
3.4.3. Endorsement conferences / rounds
3.5. Conferences with family members
( ) 4. The pediatric procedures are included in the technical skills training part of the
program.
( ) 6. The latest editions of the HAB-required textbooks, journals, and PPS publications are
available at the department’s library.
( ) MEAN
Evaluation
31 | P a g e
( ) 2. The following areas of clinical competence are evaluated:
2.1. Knowledge
( ) 8. The results of program evaluation are utilized to enhance and revise the curriculum.
( ) MEAN
Program Outcomes
A. SB Examination
Total number of trainees during the accreditation period
32 | P a g e
Percentage of successful examinees _______
Score _______
10 – 29% ------ 1
30 – 49% ----- 2
50 – 69% ----- 3
70 – 89% ----- 4
Score _______
10 – 29% ------ 1
30 – 49% ----- 2
50 – 69% ----- 3
70 – 89% ----- 4
( ) MEAN
33 | P a g e
Input the means for each section. Multiply the means by the weights to get the product. Add the
products to get the mean for the area.
Evaluation 20
Program Outcome
a. SB Examination 15
b. WISE 5
34 | P a g e
Area 3: TRAINEES
BASIC STANDARDS
Residency is a vital step of post-medical school training. After completing medical school,
those interested in child health are highly encouraged to apply for residency.
1. The trainees are important indicators of the success of a program. To ensure that the
trainees maintain a certain standard of quality, attention must be given to the screening
process, teaching-learning activities, and retention and promotion process.
2. A minimum of three (3) trainees is required to start a residency training program. Sixty
percent (60%) of the total number of trainees per year level must be Filipino citizens.
3. The selection process of prospective trainees must be clearly described including the:
3.1. Criteria for selection
3.2. Admission process
3.3. Persons responsible for the admission process
3.4. Policies on transferees from other accredited programs
3.5. Policies on foreign medical graduates
6. The duties and responsibilities of trainees per year level, including the chief resident, must be
clearly described.
QUALITY STANDARDS
A. Admission Policies
1. The selection of trainees should be harmonized with the institutional and departmental
vision-mission-objectives. Transparency and equity should be observed in the selection
process.
2. The trainees should have a high level of understanding of the basic biomedical sciences
achieved at the undergraduate level before starting the training program.
3. The trainees should be oriented on the program content of the PPS-approved residency
training program and the aligned institutional training manual. Promoted trainees should be
reoriented prior to the next year level.
35 | P a g e
4. The admission policy should be periodically reviewed.
B. Performance
1. There should be a system to monitor the progress of trainees in the form of formative and
summative assessments, including reported unintended incidents.
2. Each trainee should have a training portfolio that is regularly monitored and evaluated by the
supervising consultants. The portfolio should contain the cases seen, procedures done,
certificates of attendance to workshops / conventions, and results of evaluations.
4. The trainee should have taken the PPS National Written In-Service Examination (WISE) at
least twice during the residency period.
5. There should be a mechanism to ensure the trainees’ representation and participation in the
following activities:
5.1. Formulation of the mission, goals, and program outcomes
5.2. Design and planning of the training program
5.3. Evaluation of the training program
6. The graduates should take the PPS Specialty Board Examination within two (2) years after
completing the program.
1. There should be a system for academic counseling, including career and guidance planning
for trainees, with utmost confidentiality in handling counseling.
3. The department should provide appropriate and equitable remuneration and benefits,
including legally mandated training interruptions (pregnancy, sickness, bereavement, and
others).
36 | P a g e
D. Promotion, Retention, and Dismissal
1. There should be clear policies on the promotion, retention, and dismissal of trainees. These
policies should be made known to them.
2. The department should provide a mechanism for grievance and appeal against decisions
involving:
2.1. Admission to the program
2.2. Disciplinary sanctions
2.3. Retention
2.4. Dismissal from the program
EVALUATION INSTRUMENT
NA Not applicable
37 | P a g e
INSTRUCTIONS: Following the rating scale definition, write the assessment that best describes to
what extent the provisions of the standards are met inside the parenthesis.
Admission Policies
( ) 2. The admission policies of the department are consistent with governmental and
institutional regulations and conform with the vision-mission-objectives of the
institution and the department.
( ) 3. The criteria for selection of trainees are effective in identifying individuals capable of
undergoing pediatric residency and includes:
3.1. Undergraduate performance (class rank)
3.2. Aptitude examination
3.3. Interview
3.4. Other qualities
( ) 5. The trainees are oriented on the program content of the PPS-approved residency
training program and the aligned institutional training manual. Promoted trainees
are reoriented prior to the next year level.
( ) MEAN
Performance
( ) 1. The duties and responsibilities of trainees per year level, including the chief resident,
are clearly described.
( ) 2. There is a system to monitor the progress of trainees in the form of formative and
summative assessments, including reported unintended incidents.
( ) 3. Each trainee has a training portfolio that is regularly monitored and evaluated by the
supervising consultants.
38 | P a g e
( ) 4. There is a mechanism to ensure the trainees’ representation and participation in the
following activities:
4.1. Formulation of the mission, goals, and program outcomes
4.2. Design and planning of the training program
4.3. Evaluation of the training program
( ) MEAN
( ) 1. There is a system for academic counseling, including career and guidance planning
for trainees.
( ) MEAN
( ) 1. There are clear policies on the promotion, retention, and dismissal of trainees. These
policies are made known to them.
2. The department should provide a mechanism for grievance and appeal against
decisions involving:
2.1. Admission to the program
2.2. Disciplinary sanctions
2.3. Retention
2.4. Dismissal from the program
MEAN
39 | P a g e
Input the means for each section. Multiply the means by the weights to get the product. Add the
products to get the mean for the area.
Admission Policies 15
Performance 40
40 | P a g e
AREA 4: CONSULTANTS
BASIC STANDARDS
1. All consultants must be board certified (Diplomate or Fellow) by the Philippine Pediatric
Society.
2. There must be a formal mechanism for the recruitment and selection of consultants.
3. The consultants and residents must observe the Code of Ethics of PMA and PPS.
QUALITY STANDARDS
1. There should be a formal mechanism for the recruitment and selection of consultants.
B. Academic Qualifications
1. The qualifications of each group of consultants (active vs visiting, or any other distinction
present) should be clearly specified.
41 | P a g e
C. Performance
1. The duties and responsibilities of each group of consultants (active vs visiting, or any other
distinction present) should be clearly specified.
2. The consultants should participate in the different activities of the department including
training activities, service, research, formulation of policies, and evaluation of trainees.
4. There should be harmonious relationships between the administration and the department,
and within the department.
D. Benefits
1. There should be incentives for the consultants’ participation in the teaching program
(decking of private walk-in admissions, offices, parking spaces, and others).
2. There should be provisions for recognition and reward for meritorious activities of
consultants (plaques of recognition, citations, gifts, and others).
3. The department should have a staff development program to enhance their professional
roles, and provisions to attend teacher training seminars and participation in scientific
conferences.
4. There should be activities that promote the consultants’ well-being and welfare.
EVALUATION INSTRUMENT
42 | P a g e
2 Fair compliance Meets few provisions of the standard
NA Not applicable
INSTRUCTIONS: Following the rating scale definition, write the assessment that best describes to
what extent the provisions of the standards are met inside the parenthesis.
( ) MEAN
Academic Qualifications
( ) MEAN
Performance
( ) 1. The duties and responsibilities of each group of consultants (active vs visiting, or any
other distinction present) are clearly specified.
( ) 4. The consultants observe the Codes of Ethics of the PMA and PPS.
43 | P a g e
( ) 5. There are harmonious relationships between the administration and the
department, and within the department.
( ) MEAN
Benefits
( ) 1. There are incentives for the consultants’ participation in the teaching program.
( ) 2. There are provisions for recognition and reward for meritorious activities of
consultants.
( ) 4. There are activities that promotes the consultants’ well-being and welfare.
( ) MEAN
Input the means for each section. Multiply the means by the weights to get the product. Add the
products to get the mean for the area.
20
Recruitment and Selection
25
Academic Qualifications
30
Performance
25
Benefits
100
AREA MEAN
44 | P a g e
AREA 5: ADMINISTRATION
BASIC STANDARDS
1. The department must have an administrative organization which facilitates the attainment of
its vision, mission, and objectives. The governance structures and functions of the
department should be defined including the relationship with the hospital and / or university.
2. The administrative structure must include appropriate officers, sections and committees, and
should reflect the representation of consultants and residents.
3. The chair and training officer must be Fellows of the PPS. A Fellow must chair only one (1)
HAB-accredited training program.
QUALITY STANDARDS
A. Administrative Organization
1. The department should have an organizational structure defining the training, service, and
research functions, as well as governance (including its relationships with the hospital
administration and / or university).
2. The qualifications and job descriptions of the following departmental officers should be
defined:
2.1. Chair
2.2. Training officer
2.3. Section chief
2.4. Committee heads
3. The staffing pattern in all pediatric patient care areas should be described including:
3.1. Number of beds per service area
3.2. Number of personnel per service area
3.2.1. Residents
3.2.2. Nurses
3.2.3. Midwives
3.2.4. Other healthcare providers
4. There should be open communication lines among the hospital and / or university,
department, consultants, trainees, and other healthcare providers.
5. The department should have working linkages with other institutions involved in child
healthcare.
45 | P a g e
B. Planning and Financial Management
2. The planning sessions should involve the consultants and residents with provisions for the
participation of the alumni in the affairs of the department.
3. The department should have immediate (5 years) and long-range (10 years) plans.
4. The hospital and / or university should allocate resources to implement the programs of the
department.
1. The records of departmental meetings, planning sessions, data of consultants and residents,
official rules and policies, and reports should be kept on file.
3. The department should follow proper policies and procedures to ensure the confidentiality
of the trainees’ records.
4. The department should be up to date in the submission of the ICD 10 report requirements to
PPS.
a. The report should be submitted on time (on the third Friday of the following month)
b. The report should be accurate as assessed by a Clearing-House Committee headed by
either the Training Officer or Research Committee Chair created for this purpose.
The department chair should sign the submitted report.
c. The acknowledgement of the submission of ICD 10 reports should be kept on file.
46 | P a g e
EVALUATION INSTRUMENT
NA Not applicable
INSTRUCTIONS: Following the rating scale definition, write the assessment that best describes to
what extent the provisions of the standards are met inside the parenthesis.
Administrative Organization
( ) 1. The hospital and / or university has an organizational structure which details and
relationships and governance of the different departments.
( ) 2. The department has an organizational structure defining the training, service, and
research functions, as well as governance (including its relationships with the
hospital administration and / or university).
( ) 3. The qualifications and job descriptions of the departmental officers are defined.
( ) 4. The staffing pattern in all pediatric patient care areas is described including the
number of beds and personnel per service area.
( ) 5. There are open communication lines among the hospital and / or university,
department, consultants, trainees, and other healthcare providers.
( ) 6. The department has working linkages with other institutions involved in child
healthcare.
( ) MEAN
47 | P a g e
( ) 2. The planning sessions involve the consultants and residents with provisions for the
participation of the alumni in the affairs of the department.
( ) 3. The department has immediate (5 years) and long-range (10 years) plans.
( ) 4. The hospital and / or university allocates resources to implement the programs of the
department.
( ) MEAN
( ) 3. The department follows proper policies and procedures to ensure the confidentiality
of the trainees’ records.
( ) 4. The department submits an accurate ICD 10 report on time assessed by the Clearing-
House Committee and signed by the department chair.
( ) MEAN
Input the means for each section. Multiply the means by the weights to get the product. Add the
products to get the mean for the area.
Administrative Organization 50
ICD 10 15
48 | P a g e
AREA 6: PATIENT SERVICES AND FACILITIES
BASIC STANDARDS
1. The hospital must be Philhealth accredited and certified as a Mother-Baby Friendly Institute.
2. There must be written policies and procedures for the admission, care and discharge of
pediatric patients for each pediatric area of care (Standard Operating Procedures or Manual of
Operations).
2.1. Neonatal unit
2.2. Inpatient wards
2.3. Emergency room
2.4. Outpatient unit
2.5. PICU
2.6. Adolescent wards
3. Ten percent (10%) of the total bed capacity must be identified for service patients.
4. The minimum equipment for pediatric patient care must be available. (Appendix 3)
6. Attending physicians for patients aged 0-18 yrs. must be board certified pediatricians
(Diplomate or Fellow).
7. All patients at the emergency room aged 0-18 yrs. must be evaluated by the pediatric
resident.
8. All newborn babies shall be under the care of a board certified pediatrician (Diplomate or
Fellow). High-risk newborns must be referred to a board certified or board-eligible
neonatologist.
9. The pharmacy, laboratory, radiology and central supply room must render 24-hours service.
49 | P a g e
QUALITY STANDARDS
1. The neonatal unit should meet the standards set by the HAB and the Philippine Society of
Newborn Medicine.
1.1. Levels I and II – Neonatal Unit Level I & II respectively
1.2. Levels III and IV – Neonatal Unit Level III & IV respectively
See Appendix 5 – PPS Neonatal Unit Level Requirement
2. The Pediatric Intensive Care Unit must be Level II for Level III and IV HAB accredited
hospitals.
3. The pharmacy, laboratory, radiology, and central supply room should render 24-hour
services.
4. The physical plant should provide for safety, cleanliness, comfort, and space provisions for
patient care and training activities.
A. Patient Services
1. There should be a sufficient number of patients to satisfy the training objectives. The
minimum number of patients per area per month should be:
1.1. ER consultations 120 – 150
1.2. OPD consultations 90 – 100
1.3. Well baby / child consultations 50 – 60
1.4. Deliveries 20 – 30
1.5. In-patient admissions 50 – 60
1.6. Adolescents (in- and out-patients) 20 – 30
3. The minimum equipment for patient care outlined in Appendix 3 should be available.
50 | P a g e
B. Human Resources
1. The attending physicians for all patients aged 0 – 18 years should be managed by board-
certified pediatricians.
2. All patients aged 0 – 18 years at the emergency room should be evaluated by the pediatric
resident.
3. All newborns should be under the care of a board-certified pediatrician. High risk newborns
should be referred to a board-certified or board-eligible neonatologist.
EVALUATION INSTRUMENT
NA Not applicable
51 | P a g e
INSTRUCTIONS: Following the rating scale definition, write the assessment that best describes to
what extent the provisions of the standards are met inside the parenthesis.
( ) 1. There are written policies and procedures for the admission, care, and discharge of
patients for the following service areas:
1.1. Emergency room
1.2. Outpatient unit
1.3. Neonatal unit
1.4. Rooming-in ward
1.5. In-patient wards
1.6. PICU
1.7. Adolescent wards
( ) 2. The neonatal unit meets the standards set by the HAB and the Philippine Society of
Newborn Medicine.
2.1. Levels I and II – Neonatal Unit Level I & II
2.2. Levels III and IV – Neonatal Unit Level III & IV
( ) 3. The Pediatric Intensive Care Unit (PICU) meets the standards set by the SPCCMP
3.1 Level I – PICU Level I
3.2 Level II – IV – PICU Level II
( ) 4. The pharmacy, laboratory, radiology, and central supply room render 24-hour
services.
( ) 6. The physical plant should provide for safety, cleanliness, comfort, and space
provisions for patient care and training activities.
52 | P a g e
9.1. Conference room
9.2. Department office
9.3. Call room for trainees
9.4. Multimedia resources (computer, internet facilities, and LCD projector)
( ) MEAN
Patient Services
( ) 2. At least ten percent (10%) of the total bed capacity is identified for service patients.
( ) MEAN
Human Resources
( ) 3. All newborns are under the care of a board-certified pediatrician. High-risk newborns
are referred to a board-certified or board-eligible neonatologist.
( ) MEAN
53 | P a g e
Input the means for each section. Multiply the means by the weights to get the product. Add the
products to get the mean for the area.
Patient Services 40
Human Resources 30
54 | P a g e
AREA 7: RESEARCH
BASIC STANDARDS
2. Each resident must submit a completed, well designed research paper at the end of the 3-
year residency program.
4. There must be venues for oral presentation or publication of residents’ research papers.
(Abstracts should be included in the PPS website)
QUALITY STANDARDS
1. The research agenda should be relevant to the national or regional health needs. Research
studies with social relevance in the community where the department is located should be
encouraged.
2. The hospital / department should conduct annual research lectures, seminars, or workshops
to include Evidence-Based Medicine (EBM) and Good Clinical Practice (GCP).
3. The residency program should have a protected time for research work.
4. Researches from Levels 1 – 3 programs should be submitted to the PPS Research Committee
for final approval. Researches from Level 4 programs need not be submitted to the
committee. The department’s research committee will give the final approval.
5. All PPS-published research papers shall be the property of the society. Presentations in other
scientific venues and publication in various journals will require permission from the PPS.
1. There should be a designated coordinator for research. The trainees should be given a
consultant-adviser (co-author) who will supervise them from the development of a proposal
to the completion of research.
2. All research proposals should be evaluated by the research coordinator or the research
committee of the department.
55 | P a g e
4. The trainees should be given sufficient statistical assistance by the hospital or departmental
staff, or outside personnel.
5. The trainees should avail of various research funding sources including the government, PPS,
and other private funding organizations.
C. Research Outputs
EVALUATION INSTRUMENT
NA Not applicable
56 | P a g e
INSTRUCTIONS: Following the rating scale definition, write the assessment that best describes to
what extent the provisions of the standards are met inside the parenthesis.
( ) 2. The research agenda is relevant to the national or regional health needs. Research
studies with social relevance in the community where the department is located is
encouraged.
( ) 5. There are venues for oral presentations organized by the department, hospital, the
PPS, or other organizations.
( ) MEAN
( ) 1. The trainees are given a consultant-adviser (co-author) who supervise them from the
development of a proposal to the completion of research.
( ) 2. All research proposals are evaluated by the research coordinator or the research
committee of the department.
( ) 4. The trainees are given sufficient statistical assistance by the hospital or departmental
staff, or outside personnel.
( ) MEAN
Research Outputs
( ) 1. Each trainee submits a completed research paper at the end of the 3-year residency
program.
57 | P a g e
Total number of completed researches _____
Percentage _____
Scoring
< 10% 0
10 – 29% 1
30 – 49% 2
50 – 69% 3
70 – 89% 4
> 90% 5
( ) MEAN
Input the means for each section. Multiply the means by the weights to get the product. Add the
products to get the mean for the area.
Research Outputs 40
58 | P a g e
Area 8: COMMUNITY INVOLVEMENT
For purposes of accreditation, a community is defined as a political group (purok, barangay, town or
province), institution, school, agency, or any population group outside the hospital identified by the
department for its community involvement program.
BASIC STANDARDS
1. The department must have a formal written community program that includes objectives,
content, learning strategies, and evaluation criteria.
QUALITY STANDARDS
1. The community involvement program should provide opportunities for trainees to develop
skills in community and ambulatory pediatrics, health planning, and providing health services.
2. The department’s vision-mission, projects and services must be made known to the
community. (i.e., general assembly, meeting with leaders, newsletter, etc.)
4. At least one (1) strategy should be implemented to give the trainees an opportunity to know
the conditions and needs of the community (build community awareness). Examples are:
4.1. Meetings with community leaders
4.2. Research studies
4.3. Community projects
4.4. Field practicum
4.5. Community surveys
4.6. Interviews of key persons in the community
59 | P a g e
5. There should be evidence of measurable outcomes/impact of the programs/strategy.
6. There should be an active and functioning referral system between the community and the
hospital.
9. The community program should be evaluated regularly by the department based on the
expected outcomes.
B. Community Involvement
1. Service should be rendered through at least one of the following or similar strategies:
1.1. Providing regular ambulatory clinic services for well and sick children
1.2. Participation in the work of government and non-government organizations, schools,
civic, and religious groups
1.3. Conducting own community service projects (environmental health, botika sa
barangay, training of barangay health workers, and others)
1.4. Participation in the provision of primary health care services (EPI, CDD, CARI)
1.5. Participation in public health education sessions (mothers’ class)
1.6. Participation in the services for the promotion of children’s health (child safety,
proper parenting and child care, reproductive health, school health, anti-smoking,
alcohol and drugs, sports and other wellness programs, TB-DOTS, child protection)
1.7. Participation in the provision of services for disadvantaged children (out of school
youth, juvenile delinquents, homeless, street children)
2. The service in the community should be rendered following the frequency recommended by
the HAB:
2.1. Level I – at least twice weekly (half day)
2.2. Level II – thrice weekly (half day)
2.3. Levels III and IV – daily (whole or half day)
5. Health promotion and disease prevention should be emphasized in the program rather than
care of the sick.
60 | P a g e
SUPPORTING DOCUMENTS TO BE INCLUDED IN THE REPORT
EVALUATION INSTRUMENT
NA Not applicable
INSTRUCTIONS: Following the rating scale definition, write the assessment that best describes to
what extent the provisions of the standards are met inside the parenthesis.
61 | P a g e
Community Programs and Policies
( ) 1. The department has a formal written community program that includes objectives,
content, learning strategies, and evaluation criteria.
( ) 3. The department’s vision-mission, projects, and services are made known to the
community.
( ) 6. At least one (1) strategy was implemented to give the trainees an opportunity to
know the conditions and needs of the community. Check the appropriate box.
( ) 7. There is an active and functioning referral system between the community and the
hospital.
( ) 8. There is a MOA between the department / hospital and the community to provide
safety measures for the trainees.
( ) MEAN
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Community Involvement
( ) 1. Service is rendered through at least two of the following strategies (Check the
appropriate box):
1.1. Providing regular ambulatory clinic services for well and sick children _____
1.4. Participation in the provision of primary health care services (EPI, _____
CDD, CARI)
1.6. Participation in the services for the promotion of children’s health _____
(child safety, proper parenting and child care, reproductive health,
school health, anti-smoking, alcohol and drugs, sports and other
wellness programs, TB-DOTS, child protection)
Scoring Score
Number of strategies: 2 1
3 2
4 3
5 4
>6 5
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( ) 2. The service in the community is rendered following the frequency recommended by
the HAB:
2.1. Level I – at least twice weekly (half day)
2.2. Level II – thrice weekly (half day)
2.3. Levels III and IV – daily (whole or half day)
4. Health promotion and disease prevention is emphasized in the program rather than
care of the sick.
( ) MEAN
Input the means for each section. Multiply the means by the weights to get the product. Add the
products to get the mean for the area.
Community Involvement 60
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WEIGHT VALUES FOR THE OVERALL RATING
Training Program 5 X 10 50
Trainees 5 X 10 = 50
Consultants 5 X 10 = 50
Administration 5 X 4 = 20
Research 5 X 6 = 30
Community Involvement 5 X 4 = 20
50 250
Enter the means for each area of evaluation. Supposing each area got a mean of 5, write 5 in each box
under column 2.
Multiply each mean by the WEIGHT VALUE to get the PRODUCT.
Get the sum of the products and divide it by 50 to get the average.
Sum of Products = Average
50
250 = 5 (the highest possible rating if each area gets the highest possible mean)
50
(See Appendix 7 – Summary of all documents to be submitted by hospital applying for
accreditation/reaccreditation)
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APPENDICES
APPENDIX 1
Evaluation Area Whom to Interview Coverage Written Materials to Review Facilities to Inspect
Interview
1. Training Program Department Chair Residency training program Residency training program Conference room
Training Officer Supervision of training Schedule of training Patient care areas
Consultants (as Innovations or electives for activities, lectures, clinical Library
many) Residents conferences Audio-visual
Chief Resident Evaluation system Evaluation system and forms equipment
Resident Physicians Enrichment Schedule of duties/rotation
(as many) opportunities/Program Schedule of outside hospital
Outside hospital rotation for rotation
Subspecialties Access to textbooks/journals
Use of library and resource Library acquisitions/holdings
center/access to academic Patient records/charts
materials Recommended incentive and
Community outreach sanctions
program Written procedure for
co-Curricular activities infraction for academic &
Participation in inter- non-academic issues
hospital integrated program Communication from
Issues encountered Committee on Education of
Grievance procedure the Hospital Accreditation
Board of the WISE
performance for the past
three (3) years
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Evaluation Area Whom to Interview Coverage Written Materials to Review Facilities to Inspect
Interview
4. Administration Hospital Director Vision-mission of the Vision-mission of the hospital Offices
Asst. Directors/ hospital and department and department
Chief of Clinics Organizational plan/chart Organizational plan/chart
Department Chair Job description of section Job descriptions
Training Officer chiefs Development plans – long
Staffing pattern in patient and short term
care areas Data privacy manual
Clerical support Compliance with
Department budget DOH/Philhealth & other
Sources/allocation of funds regulatory agencies
Department’s short and Written plan for archiving
long range plans
Data privacy regulation
Implementation of gov’t
mandated laws & policies
5. Patient Service and Consultants-in- Policies and procedures in Standard Operation Newborn services
Facilities charge of various the admission, care and Procedures or Rules and Wards
patient areas discharge of patients in all Policies in all pediatric areas E.R.
Department Chair pediatric cares of care: of care: OPD
Chief Resident - Newborn services - Newborn services Pedia ICU
Consultants - Wards - Wards CPU
Residents - Emergency Room - Emergency Toom Laboratory
Pediatric area head - Outpatient - Outpatient Radiology
nurses - Pedia ICU - Pedia ICU Equipment
- Subspecialty - Subspecialty clinic Supplies
clinic Formulary Library & resource
- Medical Patient records/chart center
equipment Use of growth and other PPS Conference room
- Drugs and recommended forms Call rooms
medical supplies Development and Pedia office
maintenance program for Restrooms
Development and equipment and physical plant
maintenance program for Calibration of medical
equipment and physical equipment
plant
SOPs for use of various
hospital facilities
Disaster plan of hospital
6. Research Consultant-in- GCP Written plan for research Library & resource
charge Conduct of research Research papers of residents center
Department Head IRB/Ethics review and consultants
Chief Resident List of research in past years
Consultants Consultants w/ GCP
Residents certification
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Evaluation Area Whom to Interview Coverage Written Materials to Review Facilities to Inspect
Interview
7. Community Consultant-in- Characteristics of the Basic data/ description of the The actual
Involvement charge community (or the school, community or population community, agency
Department Head agency, institution or group institution of
Chief Resident population group) The Community Outreach population group
Residents Resources available in the Program
Consultants community Researches done by residents
Socio-economic, concerning the community
environmental & health Updated MOA
needs of the community Outcomes/impact (Levels III
Relationship of the hospital and IV)
(Dept. Of Pediatrics) with
the other sectors of the
community (i.e. NGO’s,
government agencies,
schools, church groups,
business groups)
The Department’s
contribution to the
community’s development
The community’s
contribution to the growth
of the hospital/ Department
of Pediatrics
Details of the Community
Outreach Program
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APPENDIX 2
NICU 2
Ward 4
Second year
(12 months) OPD/ER 3
NICU 2
Ward 3
Third year
(12 months) OPD/ER 2
NICU 2
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APPENDIX 3
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APPENDIX 4
PPS REQUIRED TEXTBOOKS AND JOURNALS
(The list is updated regularly in separate communications to the accredited program/department)
The latest edition of the following books and journals must be available at all times:
A. Basic textbooks
B. Main Journals
1. Anthropometrics PPS/FNRI
2. Standards of Child Care
3. Standards of Newborn Care
4. CCD Manual
5. Handbook of Pediatric Infectious Diseases
6. Handbook on Newborn Care
7. Core Pediatrics
8. Tuberculosis in Infancy and Childhood
9. National Consensus on Childhood TB
10. IMCI / CATT WHO
11. Preventive Health Care Manual
12. CPGs
13. Policy Statements
14. Proceedings of PPS Annual Convention
15. Undergraduate Pediatric Curriculum Manual and other UPEC teaching modules.
16. ICD 10
17. PPS Code of Ethics
18. PMA Code of Ethics
19. PPS Accreditation Manual
20.Child Protection Manual
21. Childhood Immunization Schedule
22. Other new PPS publications
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D. The pediatric library shall have a book or reference on ALL pediatric subspecialties. In addition,
books on the following topics shall be available.
1. Adolescent Medicine
2. Ambulatory Pediatrics
3. Child Development and Behavior Problems
4. Child Psychiatry
5. Critical Care
6. Diseases of the Newborn
7. Emergency Pediatrics
8. Genetics
9. Oncology
10. Pediatric Pharmacology and Therapeutics
11. Philippine National Drug Formulary
12. Poisoning and Toxicology
13. Fundamentals of Pediatrics: A Competency Based Approach
14. Red Book
15. Fe del Mundo Textbook of Pediatrics
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Appendix 5
A Neonatal Intensive Care Unit (NICU) is a unit with appropriate resources and staff skilled in the
provision of newborn care, with higher level units deemed capable of managing premature babies
and more critically ill newborns. A system of classification will enable the following:
1) Provide definitions for classification of NICUs based on the increasing complexity of neonatal
care, which will be used for institutions with pediatric residency training programs
2) Provide the local standards for each level that facilities can aspire to achieve
3) Mapping of facilities in terms of their capacity to provide neonatal care, that will
subsequently designate their role in the service delivery network in each region
The NEOHAB improves on the previous classification of newborn care services contained in 4th
edition of the Philippine Society of Newborn Medicine’s Standards of Newborn Care 2017 by the
addition of protocols and procedures and statistical data collection. Identification of the capabilities
of each facility will improve neonatal outcomes since it will allow recognition of high-risk neonates
that need to be referred to higher level centers with the suitable resources and skilled personnel.
The statistics will allow monitoring of neonatal morbidity and mortality and track outcomes for each
facility.
The classification of levels of care is based on the evaluation of the following areas of concern:
I. Level of Care –therapies and services provided
II. Patient Category –based on gestational age, birth weight, severity of illness
III. Laboratory/ Ancillary Services Available – including but not limited to diagnostic, imaging and
screening studies. Classification will be based on availability of the tests, and evaluations may
be outsourced without downgrading the level of care
IV. Structural Requirement – recommendations for physical plant, with some being optional for
a specific level
V. Functional Areas - some areas considered optional for a specific level
VI. Human Resources - medical, nursing and ancillary staff and their qualifications; may be
visiting consultants
VII. Equipment – supplies and machines appropriate to the level of care provided
VIII. Records (Hospital Information System) – systematic documentation of each individual
neonate cared for by the institution
IX. Protocols & Procedures – documents on the specific plan of management (protocol) and
standard steps (procedure) done for common neonatal conditions
X. Statistical Report –indices on neonatal birth, morbidity and mortality
XI. Certifications – mandatory certifications relevant to newborn care required for licensing of
health care facilities
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NEOHAB CLASSIFICATION OF NEONATAL UNITS
• Ventilatory support
(nasal CPAP)
• Kangaroo Mother
Care
Note:
Level II patients must
be referred to a
neonatologist
II. PATIENT • Full term 37-42 Level I plus the Level II plus the Level III plus the
CATEGORY weeks following: following: following:
• Preterm 34 or • Gestational age ≥32 • Referral Center • Infants with
more weeks • Any sick infant up to complex
completed • Gestational ≥ 42 44 weeks post- congenital
weeks AGA weeks conceptional age anomalies
(birth weight ≥ • Stable NB > 32 needing medical and • Infants
2000 gm) weeks and > 1500 g surgical care requiring
for transfer • Infants < 32 weeks ECMO
Note: • SGA and <1500 g
If unstable, • LGA
transfer to higher
level of care
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III. LABORATORY/ Available 24 hours: Level I plus the Level II plus the Level III plus the
ANCILLARY • Laboratory – following: following: following:
SERVICES CBC, CBG • Laboratory – • Ultrasound • Drug levels
AVAILABLE • Radiology Biochemistry (portable) determination
• ENBS • Radiology + trained • CT scan
• OAE testing staff • MRI
• CCHD screening • Blood Bank • Echocardiography
• Microbiology (portable)
• Serology • Ophthalmologic
• Portable x-ray screening
machine • Pharmacy with life-
• Pharmacy saving drugs, e.g.
surfactant
• Human Milk Storage
Facility
• Human Milk Bank -
optional
IV. STRUCTURAL • Proximity to Level I plus the Level II plus the Same as Level III
REQUIREMENT Delivery Room following: following:
• Good lighting • Oxygen & • Piped-in oxygen and
• 1 Sink for every compressed air compressed air
6-8 patients • Foot
• Electrical outlets -knee/elbow or
(at least four per sensor operated
functional area) scrub sink
• Oxygen
V. FUNCTIONAL • Handwashing Level I plus the Level II plus the Same as Level III
AREAS Area following: following:
• Resuscitation/ • Intermediate Room • Conference Room
Admitting Area (Special • Bereavement Area
• Breastfeeding Care/Continuing
Area/ Kangaroo Care/Step-down
Care Area Area)
• Storage area for • Intensive Care
supplies & Room
equipment • Isolation Room
• Nurses’ Station/ • Conference Room
Clerical Area - optional
• Utility Room
(clean & dirty)
• Staff
Room/Quarters
• Intermediate
Room
- optional
• Conference
Room
- optional
Note: Lower units may re-admit patients from higher level units for continuing care
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VI. HUMAN
RESOURCES
1. Training 80% of staff in 80% of staff in Same as Level II Same as Level II
newborn care maternal & newborn
trained in: care trained in:
• NRPh+ • NRPh+
• Lactation • Lactation
Management Management
Training (LMT) Training (LMT)
• Care of the Small
Baby (CSB)
2. Medical Staff
a. Pediatrician/ • Board Certified • Board Certified • Board Certified Same as Level III
Neonatologist Pediatrician Neonatologist Neonatologist
• Board Eligible
Neonatologist (in
the absence of a
board certified
neonatologist) –
should be certified
within 2 years after
accreditation visit
• Board Certified
Pediatrician
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d. Other Pediatric • Radiologist • Pediatric Radiologist Same as Level III
Subspecialists • Infection Control • Infection Control
Committee Committee
• Pediatric
Anesthesiologist
• Rehabilitation
Medicine
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Neonatal resus. radiant warmer • PICC Line set • ECMO
bag with • Transport incubator • Thoracostomy set capability
preterm/term • CPAP machine • Therapeutic - optional
mask sizes • Umbilical hypothermia • Research
Endotracheal catheterization set capability facility – with
tubes • Exchange • High frequency trained
Fr 2.5, 3.0, 3.5, transfusion set ventilator research staff
4.0) • KMC reclining chair - optional and
• Resuscitation • Freezer for breast equipment
Table milk storage
• Radiant warmer • Mechanical
or secure ventilator
overhead source - optional
of heat • ABG machine
• Pulse oximeter - optional
• Stethoscopes • Oxygen blender
• NIBP apparatus - optional
with neonatal
cuff
• Suction
machines with
pressure
regulator
• Phototherapy
units
• Clock or timer
• Digital
thermometers
• Non-mercury
room
thermometers
• Weighing scale,
preferable
digital
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NICU and Care (KMC) Method
admission set up • Infection Control
and care (Antimicrobial
guidelines surveillance –
• Breastfeeding/ monthly
Lactation monitoring/
Management hospital
antibiogram)
Procedures • Neonatal Level I plus the Level II plus the Same as Level III
resuscitation following: following:
• Newborn • Lumbar tap • Endotracheal
metabolic • Blood transfusion intubation
screening • Retinopathy of • Peripherally Inserted
(Expanded NBS) Prematurity Central Catheter
• Newborn Screening (PICC) line insertion
hearing • Phototherapy • Needling
screening • Surfactant • Thoracentesis
(Otoacoustic administration • Thoracostomy tube
emissions • Umbilical insertion
testing) cannulation
• Critical • Double volume
congenital heart exchange
disease (CCHD) transfusion
screening • Ventilatory support
• Red orange
reflex (ROR)
screening
X. STATISTICAL
REPORT
1) Total number Level I plus the Same as Level II Same as Level II
of live births following:
2) Manner of 1) Morbidity rates
delivery (NSD, (no. of cases/
CS, etc.) total live births)
3) Total number for specific
of admissions conditions
a. Admissions including, but not
according to limited to:
maturity and a. Prematurity
weight for b. Asphyxia
age c. Sepsis and
b. Admissions severe
according to infections
sex d. Congenital
c. Leading anomalies
causes of 2) Total number of
admissions mortalities/morta
4) Practice of lity rates
EINC (4 Core a. Perinatal death
steps) rate = (no. of
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a. Complete stillbirths +
b. Incomplete neonatal deaths/
5) Practice of total number of
Breastfeeding deliveries) x
a. Breastfeedin 1000
g initiation b. Neonatal
within an mortality rate =
hour after (no. of deaths
birth before 28 days/
b. Breastfeedin total live births)
g rate until x 1000
discharge c. Cause-specific
6) Newborn mortality rates
metabolic (Preterm,
screening asphyxia, sepsis
(ENBS) rate and severe
7) Newborn infections,
hearing congenital
screening (OAE anomalies)
testing) rate d. Case fatality
8) CCHD screening rates (Preterm,
rate term, low birth
9) ROR screening weight,
rate asphyxia, sepsis)
e. Leading causes
of mortalities
3) Antenatal steroid
use and newborn
outcomes
a. No. of
preterms whose
mothers
received at least
one dose of
antenatal
steroid/
preterms less
than 34 weeks
AOG x 100
b. No. of preterm
deaths from
respiratory
distress
syndrome
(RDS)/ no. of
preterms whose
mothers
received at least
one dose of
antenatal
steroid
4) Surfactant use
and patient
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outcomes
a. No. of preterms
who received
one dose of
surfactant/
preterms with
RDS
b. No. of preterm
deaths from
RDS/ no. of
preterms who
received one
dose of
surfactant
5) Practice of KMC
a. Number of
eligible patients
b. Number of
enrolled
patients
c. Patient
outcomes
(discharged,
mortality)
6) Retinopathy of
Prematurity
(ROP) screening
rate
XI. CERTIFICATIONS
MBFHI Full Accreditation Full Accreditation Full Accreditation Full
Accreditation
References:
1. PPS HAB 2013
2. Hernandez EA, Matias AD, Santos W. & Salazar, J. B. (2017). ‘Ethics in Perinatal Care’ in
Standards of Newborn Care (4th ed.), Philippine Society of Newborn Medicine, Quezon City,
Philippines
3. Department Order 2017- Establishment of Neonatology Centers in Selected Department of
Health (DOH) Hospitals
4. Self-assessment Tool for the Z Benefits for Premature and Small Newborns
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NEOHAB Assessment Checklist for Classification of Neonatal Units
Date of Assessment:
Name of Institution:
Instructions:
1. Indicate compliance with requirement by placing a check ( ) in the column after the description.
2. For parameters with additive components, ex: Level II (Level I plus the following):, please check all that
apply.
3. Classification of Level of Care will be filled up last.
REQUIREMENT REMARKS
I. LEVEL OF CARE
Level I: Well Newborn Unit
Level II: Special Care Unit
Level III: Neonatal Intensive Care Unit
Level IV: Referral NICU
Classification of Level of Care:
II. PATIENT CATEGORY
Level I:
Full term
Stable preterm ≥ 34 weeks (BW ≥ 2000 g)
(Note: If unstable, transfer to higher level of care)
Level II (Level I plus the following):
Preterm ≥ 32 weeks
Post-term ≥ 42 weeks
Stable preterm ≥ 32 weeks and > 1500 g for transfer
Small for gestational age
Large for gestational age
Level III (Level II plus the following):
Sick neonates up to 44 weeks post-conceptional age
< 32 weeks and <1500 g
Level IV (Level III plus the following):
Infants with complex congenital anomalies
Infants requiring ECMO
Classification of Patient Category:
III. LABORATORY/ ANCILLARY SERVICES AVAILABLE
Level I:
Laboratory – CBC, CBG
Radiology
ENBS
OAE testing
CCHD screening
Level II (Level I plus the following):
Laboratory –Biochemistry
Radiology + trained staff
Blood Bank
Microbiology
Serology
X-ray machine (portable)
Pharmacy
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Level III (Level II plus the following):
Ultrasound (portable)
CT scan
MRI
Echocardiography (portable)
Ophthalmologic screening
Pharmacy with life-saving drugs, e.g. surfactant
Human Milk Storage Facility
Human Milk Bank - optional
Level IV (Level III plus the following):
Drug levels determination
Classification of Laboratory/Ancillary Services Available:
IV. STRUCTURAL REQUIREMENT
Level I:
Proximity to Delivery Room
Good lighting
1 Sink for every 6-8 patients
Electrical outlets (at least four per functional area)
Oxygen
Compressed air
Level II (Level I plus the following):
Oxygen and compressed air
Foot-knee/elbow or sensor operated scrub sink
Level III-IV (Level II plus the following):
Piped-in oxygen and compressed air
Classification of Structural Requirement:
V. FUNCTIONAL AREAS
Level I:
Handwashing Area
Resuscitation/Admitting Area
Breastfeeding Area/ Kangaroo Care Area
Storage area for supplies and equipment
Nurses’ Station/Clerical Area
Utility Room (clean & dirty)
Staff Room/Quarters
Level II (Level I plus the following):
Intermediate Room (Special Care/Continuing Care/Step-down Area)
Intensive Care Room
Isolation Room
Level III-IV (Level II plus the following):
Conference Room
Bereavement Area
Classification of Functional Areas:
VI. HUMAN RESOURCES
1. Training
Level I (80% of newborn care staff trained):
Philippine Essential Newborn Care and Resuscitation Program (NRPh+)
Lactation Management Training (LMT)
Level II-IV (80% of staff in maternal and newborn care trained):
Philippine Essential Newborn Care and Resuscitation Program (NRPh+)
Lactation Management Training (LMT)
Care of the Small Baby (CSB)
2. Medical Staff
a. Pediatrician/ Neonatologist
Level I:
Board Certified Pediatrician
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Level II:
Board Certified Neonatologist
Board Eligible Neonatologist – should be certified within 2 years
Board Certified Pediatrician
Level III-IV:
Board Certified Neonatologist
b. Pediatric Medical Subspecialists
Level II:
Cardiologist
Level III-IV (Level II plus the following):
Neurologist
Hematologist
Infectious Disease specialist
Gastroenterologist
Pulmonologist
Endocrinologist – on call
Developmental Pediatrician – on call
Geneticist – on call
c. Pediatric Surgery Subspecialists
Level II:
Pediatric Surgeon
Ophthalmologist
Otorhinolaryngologist (ENT)
Level III-IV (Level II plus the following):
Pediatric Ophthalmologist/ Retina specialist
Cardiovascular Surgeon (TCVS)
Neurosurgeon
Orthopedic Surgeon
Urologist
d. Other Pediatric Subspecialists
Level II:
Radiologist
Infection Control Committee
Level III-IV (Level II plus the following):
Pediatric Radiologist
Infection Control Committee
Pediatric Anesthesiologist
Rehabilitation Medicine
e. Pediatric Residents
Level I:
Year I Resident
Level II-IV:
Year II-III Residents
3. Nursing Staff
Level I:
Trained in perinatal care
Recognizes need for transfer or referral to higher level facility
Skilled in breastfeeding techniques
Level II (Level I knowledge and skills plus the following):
Trained in O2 therapy, CPAP/ventilator use
Trained in caring for sick neonates
Trained in advanced resuscitation
Can operate NICU equipment
With Lactation Nurse
Level III-IV (Level II knowledge and skills plus the following):
Can understand principles of mechanical ventilation
4. Ideal Nurse to Patient Ratio*
Level I:
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1:6
Level II:
1:3-5
Level III-IV:
1:1-2
Special Care 1:3-5
Intermediate Care 1:5-6
5. Support Personnel
Level I:
Laboratory Technician
Radiology Technician
Level II (Level I plus the following):
Social worker
Pharmacist
Biomedical engineer - optional
Level III-IV (Level II plus the following):
Respiratory therapist
Nutritionist-Dietician
Biomedical engineer
Clinical Pharmacist - optional
Classification of Human Resources:
VII. EQUIPMENT
Level I:
Emergency Cart (with drugs and IVF)
Resuscitation set containing the following:
Laryngoscope (straight blade 0,1, 2)
Neonatal resuscitation bag with preterm/term mask sizes
Endotracheal tubes (Fr 2.5, 3.0, 3.5, 4.0)
Resuscitation Table
Radiant warmer or secure overhead source of heat
Pulse oximeter
Stethoscopes
NIBP apparatus with neonatal cuff
Suction machines with pressure regulator
Phototherapy units
Clock or timer
Digital thermometers
Non-mercury room thermometers
Weighing scale, preferable digital
Level II (Level I plus the following):
Diagnostic set (otoscope & ophthalmoscope)
Syringe/infusion pumps
Neonatal incubator/ radiant warmer
Transport incubator
CPAP machine
Umbilical catheterization set
Exchange transfusion set
KMC reclining chair
Freezer for breast milk storage
Level III (Level II plus the following):
Mechanical ventilator
ABG machine
Oxygen blender
Cardiac monitor/VS monitor
PICC Line set
Thoracostomy set
Therapeutic hypothermia capability
Level IV (Level III plus the following):
High frequency ventilator
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Research Facility
Nitric oxide machine - optional
ECMO capability - optional
Classification of Equipment:
VIII. RECORDS (Hospital Information System)
Levels I-IV:
Individual Patient Records
IX. PROTOCOLS & PROCEDURES
PROTOCOLS (including not limited to the following):
Level I:
Prevention of preterm birth and its complications
Essential Intrapartum and Newborn Care
Neonatal resuscitation (NRPh+)
Criteria for admission to the NICU and admission set up and care
guidelines
Breastfeeding/ Lactation Management
Level II (Level I plus the following):
Respiratory distress syndrome
Neonatal hyperbilirubinemia
Neonatal hypoglycemia
Neonatal hypothermia
Neonatal sepsis
Kangaroo Mother Care (KMC) Method
Infection Control (Antimicrobial surveillance – monthly monitoring/ hospital
antibiogram)
Level III-IV (Level II plus the following):
Anemia of prematurity
Intraventricular hemorrhage
Birth asphyxia
Therapeutic hypothermia
Kangaroo Mother Care (KMC) Program
PROCEDURES (including but not limited to the following):
Level I:
Neonatal resuscitation
Newborn metabolic screening (Expanded newborn screening)
Newborn hearing screening (Otoacoustic emissions testing)
Critical congenital heart disease (CCHD) screening
Red orange reflex (ROR) screening
Level II (Level I plus the following):
Lumbar tap
Blood transfusion
Retinopathy of Prematurity (ROP) Screening
Phototherapy
Surfactant administration
Umbilical cannulation
Double volume exchange transfusion
Ventilatory support
Level III-IV (Level II plus the following):
Endotracheal intubation
Peripherally Inserted Central Catheter (PICC) line insertion
Needling
Thoracentesis
Thoracostomy tube insertion
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Classification of Protocols and Procedures:
X. STATISTICAL REPORT
Level I:
Total number of live births
Manner of delivery (NSD, CS, etc.)
Total number of admissions
a. Admissions according to maturity and weight for age
b. Admissions according to sex
c. Leading causes of admissions
Practice of EINC (4 Core steps)
a. Complete
b. Incomplete
Practice of Breastfeeding
c. Breastfeeding initiation within an hour after birth
d. Breastfeeding rate until discharge
Newborn metabolic screening (ENBS) rate
Newborn hearing screening (OAE testing) rate
Critical congenital heart disease (CCHD) Screening rate
Red orange reflex (ROR) Screening rate
Level II-IV (Level I plus the following):
Morbidity rates (no. of cases/ total live births):
a. Prematurity
b. Asphyxia
c. Sepsis and severe infections
d. Congenital anomalies
Total number of mortalities/mortality rates
a. Perinatal death rate = (no. of stillbirths + neonatal deaths/ total
number of deliveries) x 1000
b. Neonatal mortality rate = (no. of deaths before 28 days/ total live
births) x 1000
c. Cause-specific mortality rates (Preterm, asphyxia, sepsis and
severe infections, congenital anomalies)
d. Case fatality rates (Preterm, term, low birth weight, asphyxia,
sepsis)
e. Leading causes of mortalities
Antenatal steroid use and newborn outcomes
a. No. of preterms whose mothers received at least one dose of
antenatal steroid/ preterms less than 34 weeks AOG x 100
b. No. of preterm deaths from respiratory distress syndrome (RDS)/
no. of preterms whose mothers received at least one dose of
antenatal steroid
Surfactant use and patient outcomes
c. No. of preterms who received one dose of surfactant/ preterms with
RDS
d. No. of preterm deaths from RDS/ no. of preterms who received one
dose of surfactant
Practice of KMC
a. Number of eligible patients
b. Number of enrolled patients
c. Patient outcomes (discharged, mortality)
Retinopathy of Prematurity (ROP) Screening rate
Classification of Statistical Report:
XI. CERTIFICATIONS
Levels I-IV:
MBFHI Full Accreditation
*May be lenient with the requirement
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APPENDIX 6
Name of Institution:
Date:
The Philippine Pediatric Society Hospital Accreditation Board (PPS HAB) requires that all
residents-in-training should be exposed to the management of critically-ill pediatric patients in a
designated pediatric intensive care unit during their second and third year. In order to fulfill this,
residents will need to rotate in a PICU designated and maintained to provide for maximum patient care
experience. In line with this, the Society of Pediatric Critical Care Medicine Philippines (SPCCMP) has set
forth certain criteria to be fulfilled by HAB-accredited hospitals which will serve to improve the level of
care given to children in need of our services wherever and whenever they may need it.
In order to establish, operate and maintain an area designated for pediatric intensive care while
preserving the minimum standards of care for critically-ill children, all PPS HAB-accredited hospitals in
the Philippines henceforth must conform to specific criteria set by the SPCCMP and approved by the
PPS.
LEVEL I PICU – the institution or hospital meets all the essential & 50% of the desired
criteria. Level I-IV PPS HAB hospitals who belong in this category can only have their
residents rotate in LEVEL II PICUs
LEVEL II PICU – the institution or hospital meets all the essential & 75% of the desired
criteria plus have at least 3 critically-ill admitted or referred patients per month. A
structured, monitored program of rotation will be expected. A PPS HAB Level I hospital
may apply to be accredited in this category; levels II-IV must be in this category. PPS
HAB Level I hospitals which cannot fulfill LEVEL II criteria must have their residents
rotate either in a Level II or III PICU
LEVEL III PICU – the institution or hospital has a highly-specialized PICU with an
accredited pediatric critical care fellowship training program
Whatever the PICU level, the hospital must have a board-certified pediatric intensivist, in either
an active or visiting capacity in the pediatric department, as its director or head. The accredited
pediatric intensivist is the designated captain of the ship while patients require intensive care
management. The hospital must exert all efforts in order to satisfy and maintain these criteria to keep
its status in succeeding accreditations.
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ESSENTIAL REQUIREMENTS ✓ REMARKS
Emergency Room
Pediatrics
Surgery
Radiology (X-ray)
Laboratory
Mortuary
POLICIES
Patient Monitoring
Safety
Infection Control
Maintenance of Equipment
Record Keeping
Periodic Review
Morbidity/Mortality
Quality of Care
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Available compressed air outlet/tank per bed
PERSONNEL
Director/Head
Physician Staff
Nursing staff
Nurse Manager
Infusion/Syringe pumps
Defibrillator
Weighing scale
Pulse Oximeter
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Intubation sets (all sizes)
Nebulizer
Ventilators (owned/rental)
Quality Improvement
Logbook of Activities
Otorhinolaryngology
Ophthalmology
Orthopedics
Toxicology/Poison Control
Rehabilitation Medicine
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PHYSICAL FACILITY INTERNAL
Isolation Room*
Staff toilet
PERSONNEL
Pediatric Subspecialist
Cardiologist*
Nephrologist
Hematologist/Oncologist
Pulmonologist*
Endocrinologist
Gastroenterologist
Allergy/Immunology
Neurologist
Infectious Disease*
Toxicologist
Pediatric Radiologist
Respiratory Therapist*
Pastoral service
Electrocardiography machine*
Electroencephalography machine
Infant warmer
Transport Monitor
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Capnograph
Accomplished by:
_________________________________
Name and signature / Date
Department chair/representative:
_________________________________
Name and signature / Date
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APPENDIX 7
Area 1: VISION-MISSION-OBJECTIVES
SUPPORTING DOCUMENTS TO BE INCLUDED IN THE REPORT
1. VMO of the institution
2. VMO of the department
EVALUATION INSTRUMENT
The accreditors should use the vision-mission-objectives as guideposts in evaluating the different
areas of the department. Since these analysis statements are not weighted, their scores are not
included in the overall computation. The following symbols should be used:
INSTRUCTIONS: Evaluate each statement using the scale provided. Write the assessment inside the
parenthesis. A numerical rating is NOT needed for this area.
( ) 6. The objectives of the residency program are aligned with the program outcomes set
by the PPS.
( ) 7. The objectives of the training program are clearly specified and attainable.
( ) 8. The objectives of the training program address the development of habits and
attitudes necessary to practice the profession with integrity and ethical conduct.
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Area 2: TRAINING PROGRAM
SUPPORTING DOCUMENTS TO BE INCLUDED IN THE REPORT
EVALUATION INSTRUMENT
Rating scale definition:
NA Not applicable
INSTRUCTIONS: Following the rating scale definition, write the assessment that best describes to
what extent the provisions of the standards are met inside the parenthesis.
( ) 1. The objectives and content are appropriate to the national and regional health needs,
and expectations / demands of the Filipino population.
( ) 2. There are well written instructional designs in general pediatrics and the
subspecialties according to year levels.
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( ) 3.2. Health educator
( ) 3.3. Researcher
( ) MEAN
( ) 3. The learning activities include the must-have activities recommended by the HAB:
3.1. Bedside rounds with the chair, training officer, or consultants
3.2. Supervised ER and OPD clinics
3.3. Supervised lectures and journal reviews
3.4. Clinical conferences
3.4.1. Case presentations (grand rounds, case discussions, diagnostic /
management conferences, and bioethics conferences)
3.4.2. Morbidity and mortality conferences
3.4.3. Endorsement conferences / rounds
3.5. Conferences with family members
( ) 4. The pediatric procedures outlined in Appendix X are included in the technical skills
training part of the program.
( ) 6. The latest editions of the HAB-required textbooks, journals, and PPS publications are
available at the department’s library.
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( ) 7.3. Neonatal Resuscitation Program
( ) MEAN
Evaluation
2.1. Knowledge
( ) 8. The results of program evaluation are utilized to enhance and revise the curriculum.
( ) MEAN
Program Outcomes
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A. SB Examination
Score
_____
< 10% -------------- 0
10 – 29% --------- 1
30 – 49% -------- 2
50 – 69% -------- 3
70 – 89% -------- 4
Score _____
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< 10% -------------- 0
10 – 29% --------- 1
30 – 49% -------- 2
50 – 69% -------- 3
70 – 89% -------- 4
( ) MEAN
Input the means for each section. Multiply the means by the weights to get the product. Add the
products to get the mean for the area.
Evaluation 20
Program Outcome 20
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Area 3: TRAINEES
SUPPORTING DOCUMENTS TO BE INCLUDED IN THE REPORT
1. Departmental policies on the selection process of prospective trainees including:
1.1. Criteria for selection
1.2. Admission process
1.3. Persons responsible for the admission process
1.4. Transferees from other accredited programs
1.5. Foreign medical graduates
2. Number of slots available per year level
3. Duties and responsibilities of trainees per year level, including the chief resident
4. Description of the assessment process of trainees indicating the formative and
summative evaluation methods
5. Salaries, benefits, and other incentives for trainees
6. Policies on the promotion, retention, and dismissal of trainees
7. Guidelines on disciplinary sanctions
8. Description of the mechanism for grievance and appeal against departmental
decisions
9. Description of the mentoring program
EVALUATION INSTRUMENT
Rating scale definition:
NA Not applicable
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INSTRUCTIONS: Following the rating scale definition, write the assessment that best describes to
what extent the provisions of the standards are met inside the parenthesis.
Admission Policies
( ) 2. The admission policies of the department are consistent with governmental and
institutional regulations and conform with the vision-mission-objectives of the
institution and the department.
( ) 3. The criteria for selection of trainees are effective in identifying individuals capable of
undergoing pediatric residency and includes:
3.1. Undergraduate performance (class rank)
3.2. Aptitude examination
3.3. Interview
3.4. Other qualities
( ) 5. The trainees are oriented on the program content of the PPS-approved residency
training program and the aligned institutional training manual. Promoted trainees
are reoriented prior to the next year level.
( ) MEAN
Performance
( ) 1. The duties and responsibilities of trainees per year level, including the chief resident,
are clearly described.
( ) 2. There is a system to monitor the progress of trainees in the form of formative and
summative assessments, including reported unintended incidents.
( ) 3. Each trainee has a training portfolio that is regularly monitored and evaluated by the
supervising consultants.
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( ) 4. There is a mechanism to ensure the trainees’ representation and participation in the
following activities:
4.1. Adequacy of clinical materials
4.2. Availability of consultants
4.3. Other available resources
( ) MEAN
( ) 1. There is a system for academic counseling, including career and guidance planning
for trainees.
( ) MEAN
( ) 1. There are clear policies on the promotion, retention, and dismissal of trainees. These
policies are made known to them.
2. The department should provide a mechanism for grievance and appeal against
decisions involving:
2.1. Admission to the program
2.2. Disciplinary sanctions
2.3. Retention
2.4. Dismissal from the program
MEAN
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Input the means for each section. Multiply the means by the weights to get the product. Add the
products to get the mean for the area.
Admission Policies 15
Performance 40
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Area 4: CONSULTANTS
SUPPORTING DOCUMENTS TO BE INCLUDED IN THE REPORT
1. Flowchart of recruitment and selection process of consultants
2. Qualifications and duties / responsibilities of each group of consultants (active vs
visiting, or any other distinction present)
3. List of consultants based on grouping (to include academic background, PPS and
subspecialty status, and professional affiliations)
4. Staff development program
5. Incentives for consultants
6. Consultants’ evaluation tool
EVALUATION INSTRUMENT
NA Not applicable
INSTRUCTIONS: Following the rating scale definition, write the assessment that best describes to
what extent the provisions of the standards are met inside the parenthesis.
( ) MEAN
Academic Qualifications
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2.4. Research expertise
2.5. Communication skills
( ) MEAN
Performance
( ) 1. The duties and responsibilities of each group of consultants (active vs visiting, or any
other distinction present) are clearly specified.
( ) 4. The consultants observe the Codes of Ethics of the PMA and PPS.
( ) MEAN
Benefits
( ) 1. There are incentives for the consultants’ participation in the teaching program.
( ) 2. There are provisions for recognition and reward for meritorious activities of
consultants.
( ) 4. There are activities that promotes the consultants’ well-being and welfare.
( ) MEAN
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Input the means for each section. Multiply the means by the weights to get the product. Add the
products to get the mean for the area.
20
Recruitment and Selection
25
Academic Qualifications
30
Performance
25
Benefits
100
AREA MEAN
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Area 5: ADMINISTRATION
SUPPORTING DOCUMENTS TO BE INCLUDED IN THE REPORT
1. Hospital organization chart
2. Departmental organizational chart
3. Qualifications and job descriptions of departmental officers
4. Staffing pattern in all pediatric service areas
5. MOA with other institutions involved in child healthcare, if any.
6. Composition and functions of the hospital or departmental bioethics committee
7. Immediate (5 years) and long-range (10 years) plans
8. Acknowledgment report of ICD 10 submission.
EVALUATION INSTRUMENT
NA Not applicable
INSTRUCTIONS: Following the rating scale definition, write the assessment that best describes to
what extent the provisions of the standards are met inside the parenthesis.
Administrative Organization
( ) 1. The hospital and / or university has an organizational structure which details and
relationships and governance of the different departments.
( ) 2. The department has an organizational structure defining the training, service, and
research functions, as well as governance (including its relationships with the
hospital administration and / or university).
( ) 3. The qualifications and job descriptions of the departmental officers are defined.
( ) 4. The staffing pattern in all pediatric patient care areas is described including the
number of beds and personnel per service area.
( ) 5. There are open communication lines among the hospital and / or university,
department, consultants, trainees, and other healthcare providers.
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( ) 6. The department has working linkages with other institutions involved in child
healthcare.
( ) MEAN
( ) 2. The planning sessions involve the consultants and residents with provisions for the
participation of the alumni in the affairs of the department.
( ) 3. The department has immediate (5 years) and long-range (10 years) plans.
( ) 4. The hospital and / or university allocates resources to implement the programs of the
department.
( ) MEAN
( ) 3. The department follows proper policies and procedures to ensure the confidentiality
of the trainees’ records.
( ) 4. The department submits an accurate ICD 10 report on time assessed by the Clearing-
House Committee and signed by the department chair.
( ) MEAN
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Input the means for each section. Multiply the means by the weights to get the product. Add the
products to get the mean for the area.
Administrative Organization 50
ICD 10 15
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Area 6: PATIENT SERVICES AND FACILITIES
SUPPORTING DOCUMENTS TO BE INCLUDED IN THE REPORT
1. Certificates of accreditation from: PhilHealth, MBF, NBS, and HS
2. Breakdown of number of beds per service areas: ER, OPD, NICU, rooming-in ward, in-
patient wards, adolescent services (in- and out-patient), and PICU
3. SOPs at the: ER, OPD, NICU, rooming-in ward, in-patient wards, and PICU
4. Total census during the accreditation period (per year) in the: ER, OPD, NICU,
rooming-in ward, in-patient wards, adolescent services (in- and out-patient), and PICU
5. Top 10 causes of morbidities during the accreditation period (per year) in the: ER,
OPD, NICU, in-patient wards, adolescent services (in- and out-patient), and PICU
6. Benchmarking data: infant mortality rate, case fatality rate of the most common
morbidities and mortalities.
7. Checklist of minimum equipment for pediatric patient care
8. In- and out-patient census during the accreditation period (per year) for the
subspecialty programs for Levels III and IV
9. Three (3) year departmental procurement plan for medicines, drugs, and equipment
10. Safety / disaster management plan
EVALUATION INSTRUMENT
Rating scale definition:
NA Not applicable
INSTRUCTIONS: Following the rating scale definition, write the assessment that best describes to
what extent the provisions of the standards are met inside the parenthesis.
( ) 1. There are written policies and procedures for the admission, care, and discharge of
patients for the following service areas:
1.1. Emergency room
1.2. Outpatient unit
1.3. Neonatal unit
1.4. Rooming-in ward
1.5. In-patient wards
1.6. PICU
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1.7. Adolescent wards
( ) 2. The neonatal unit meets the standards set by the HAB and the Philippine Society of
Newborn Medicine.
2.1. Levels I and II – Neonatal Unit Level II
2.2. Levels III and IV – Neonatal Unit Level III
( ) 3. The pharmacy, laboratory, radiology, and central supply room render 24-hour
services.
( ) 5. The physical plant should provide for safety, cleanliness, comfort, and space
provisions for patient care and training activities.
( ) MEAN
Patient Services
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( ) 2. At least ten percent (10%) of the total bed capacity is identified for service patients.
( ) MEAN
Human Resources
( ) 3. All newborns are under the care of a board-certified pediatrician. High-risk newborns
are referred to a board-certified or board-eligible neonatologist.
( ) MEAN
Input the means for each section. Multiply the means by the weights to get the product. Add the
products to get the mean for the area.
Patient Services 40
Human Resources 30
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Area 7: RESEARCH
SUPPORTING DOCUMENTS TO BE INCLUDED IN THE REPORT
1. Composition, duties, and responsibilities of the department’s research committee to
include statistician
2. Departmental research agenda
3. Research program of the department
4. Research seminars, workshops, and lectures conducted by the department / hospital
during the accreditation period
5. Research output per year during the accreditation period to include authors, source
of funding, venues / fora presented, citations / prizes won, and publication details
EVALUATION INSTRUMENT
Rating scale definition:
NA Not applicable
INSTRUCTIONS: Following the rating scale definition, write the assessment that best describes to
what extent the provisions of the standards are met inside the parenthesis.
( ) 2. The research agenda is relevant to the national or regional health needs. Research
studies with social relevance in the community where the department is located is
encouraged.
( ) 5. There are venues for oral presentations organized by the department, hospital, the
PPS, or other organizations.
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( ) MEAN
( ) 1. The trainees are given a consultant-adviser (co-author) who supervise them from the
development of a proposal to the completion of research.
( ) 2. All research proposals are evaluated by the research coordinator or the research
committee of the department.
( ) 4. The trainees are given sufficient statistical assistance by the hospital or departmental
staff, or outside personnel.
( ) MEAN
Research Outputs
( ) 1. Each trainee submits a completed research paper at the end of the 3-year
residency program.
Percentage _____
Scoring
< 10% 0
10 – 29% 1
30 – 49% 2
50 – 69% 3
70 – 89% 4
> 90% 5
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( ) 2. The completed researches are submitted for publication in various peer-reviewed
journals.
( ) MEAN
Input the means for each section. Multiply the means by the weights to get the product. Add the
products to get the mean for the area.
Research Outputs 40
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Area 8: COMMUNITY INVOLVEMENT
SUPPORTING DOCUMENTS TO BE INCLUDED IN THE REPORT
1. Instructional design for community involvement
2. Departmental community team and health team (point person) in the community
3. MOA between the hospital / department and the community
4. Community profile indicating the duration of departmental presence in the community and
the secondary data of the community.
5. Brief description of the strategies used to know the condition and needs of the community
6. Description of the public health projects of the department (include pictures and other forms
of documentation)
6.1. Include the schedule of clinics, services offered by the department, total number
of recipients of each service during the accreditation period (per year), and top 10
causes of morbidities during the accreditation period (per year) – for regular
ambulatory clinic services
6.2. Include the inclusive dates of the project, background, objective, strategy, and
results / evaluation for the following activities:
6.2.1. Participation in the work of government and non-government
organizations
6.2.2. Own community service projects
6.2.3. Participation in the services for the promotion of children’s health
6.2.4. Participation in the provision of services for disadvantaged children
6.2.5. Participation in the provision of primary health care services (EPI, CDD,
CARI)
6.3. Include the topics discussed, materials used, participants, and results of
evaluation and feedback – for participation in public health education sessions
7. Monthly schedule of trainees while on community rotation
8. Description of the referral system between the hospital and the community – including the
number of beneficiaries during the accreditation period (per year)
9. Program evaluation by the community
10. Program evaluation by the department
11. Outcome measures of program intervention or impact to community.
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EVALUATION INSTRUMENT
Rating scale definition:
NA Not applicable
INSTRUCTIONS: Following the rating scale definition, write the assessment that best describes to
what extent the provisions of the standards are met inside the parenthesis.
( ) 1. The department has a formal written community program that includes objectives,
content, learning strategies, and evaluation criteria.
( ) 3. The department’s vision-mission, projects, and services are made known to the
community.
( ) 6. At least one (1) strategy was implemented to give the trainees an opportunity to
know the conditions and needs of the community. Check the appropriate box.
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6.5. Community surveys _____
( ) 7. There is an active and functioning referral system between the community and the
hospital.
( ) 8. There is a MOA between the department / hospital and the community to provide
safety measures for the trainees.
( ) 10. The community program is evaluated regularly by the department based on the
expected outcomes.
( ) MEAN
Community Involvement
( ) 1. Service is rendered through at least two of the following strategies (Check the
appropriate box):
4.1. Providing regular ambulatory clinic services for well and sick children _____
4.4. Participation in the provision of primary health care services (EPI, _____
CDD, CARI)
4.6. Participation in the services for the promotion of children’s health _____
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(child safety, proper parenting and child care, reproductive health,
school health, anti-smoking, alcohol and drugs, sports and other
wellness programs, TB-DOTS, child protection)
3 2
4 3
5 4
>6 5
4. Health promotion and disease prevention is emphasized in the program rather than
care of the sick.
( ) MEAN
Input the means for each section. Multiply the means by the weights to get the product. Add the
products to get the mean for the area.
Community Involvement 60
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APPENDIX 8
____________________________________ _______________________
____________________________________ _______________________
___________________________________ ________________________
___________________________________ ________________________
2. BEST FEATURES
2.1 Training Program ________________________________________________
________________________________________________
________________________________________________
________________________________________________
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2.4 Administration _______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
2.6 Research
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
3. RECOMMENDATIONS
3.1 Training Program _____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
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3.3 Consultants ________________________________________________
________________________________________________
________________________________________________
_______________________________________________
_______________________________________________
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4. STATISTICAL RATING
-------------------------------------------------------------------------------------------------------------------
Statistical Rating Rating Weight Value Product
-------------------------------------------------------------------------------------------------------------------
1. Training Program [ ] x 10 = [ ]
2. Trainees [ ] x 10 = [ ]
3. Consultants [ ] x 10 = [ ]
4. Administration [ ] x 4 = [ ]
5. Patient Service & Facilities [ ] x 6 = [ ]
6. Research [ ] x 6 = [ ]
7. Community Involvement [ ] x 4 = [ ]
-----------------------------------------------------------------------------------------------------------------
50
Sum of Products
Average = --------------------- (MPL + 3.0)
Sum of Wt. Value
LEGEND
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
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6. BOARD ACTION
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
________________________________ ______________________________
President, PPS HAB Secretary
Chair, HAB
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APPENDIX 9
STATISTICAL RATING
(FOR ACCREDITOR’S USE)
Weight Values for the Overall Rating
Using the appropriate EVALUATION INSTRUMENT, enter the rating for the evaluation area
Sum of Products
----------------------------------------------- = AVERAGE
Sum of Weight Value
(50)
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APPENDIX 10
Statistical Rating
(For Self-assessment)
Weight Values for the Overall Rating
Using the appropriate EVALUATION INSTRUMENT, enter the rating for the evaluation area
Sum of Products
----------------------------------------------- = AVERAGE
Sum of Weight Value
(50)
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SECTION TWO
OUTCOME-BASED EDUCATION
PEDIATRIC RESIDENCY CURRICULUM
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PROPOSED OUTCOMES – BASED EDUCATION CURRICULUM OF THE PEDIATRIC RESIDENCY
TRAINING PROGRAM
Calendar Year 2019-2022
CHAPTER 1: INTRODUCTION
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CHAPTER 2 LEARNING OUTCOMES CHED, AGME, WFME, PRC
Each of the following Learning Outcomes (LOs) recommended by the Center for
Higher Education (CHED) is represented in all the formulated teaching activities
and are numbered accordingly:
LO1. Competently manage clinical conditions of clients in various setting
LO2. Convey information, in written and oral formats, across all types of
audiences, venues and media in a manner that can be easily understood
LO3. A. Initiate planning, organizing, implementation and evaluation of
programs and health facilities;
B. Provide clear direction, inspiration and motivation to the healthcare
team/ community
LO4. A. Utilize current research evidence in decision making as practitioner,
educator or researcher
B. Participate in research
LO5. Effectively work in teams with co-physicians and other professionals in
managing clients, institutions, projects and similar situations
LO6. A. Utilize systems-based approach in actual delivery of care
B. Network with relevant partners in solving general health problems
LO7. Update oneself through a variety of avenues for personal and
professional growth to ensure quality healthcare and patient safety
LO8. Adhere to national and international codes of conduct and legal
standards that govern the profession
LO9. Demonstrate love for one’s national heritage, respect for other cultures
and commitment to service
LO10. Adhere to the principles of relevance, equity, quality and cost
effectiveness in the delivery of healthcare to patients, families and
communities
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2. Medical Knowledge
Residents must demonstrate knowledge of established and evolving
biomedical, clinical, epidemiological and social behavioral sciences, as
well as the application of this knowledge to patient care. Residents:
(Outcome)
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(4) act in a consultative role to other physicians and health
professionals; and
(5) maintain comprehensive, timely, and legible medical records, if
applicable. [As further specified by the Review Committee]
5. Professionalism
Residents must demonstrate a commitment to carrying out
professional responsibilities and an adherence to ethical principles.
Residents are expected to demonstrate:
(1) compassion, integrity, and respect for others;
(2) responsiveness to patient needs that supersedes self interest;
(3) respect for patient privacy and autonomy;
(4) accountability to patients, society and the profession; and
Common Program Requirements
(5) sensitivity and responsiveness to a diverse patient population,
including but not limited to diversity in gender, age, culture, race,
religion, disabilities, and sexual orientation. (Outcome) [As further
specified by the Review Committee]
6. Systems-based Practice
Residents must demonstrate an awareness of and responsiveness to
the larger context and system of health care, as well as the ability to
call effectively on other resources in the system to provide optimal
health care. (Outcome) Residents are expected to:
(1) work effectively in various health care delivery settings and
systems relevant to their clinical specialty;
(2) coordinate patient care within the health care system relevant to
their clinical specialty;
(3) incorporate considerations of cost awareness and risk benefit
analysis in patient and/or population-based care as appropriate;
(4) advocate for quality patient care and optimal patient care
systems;
(5) work in inter-professional teams to enhance patient safety and
improve patient care quality; and,
(6) participate in identifying system errors and implementing
potential systems solutions. (Outcome)
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CHAPTER 3 PPS LEARNING OUTCOMES FOR PPS PEDIATRIC RESIDENCY
TRAINING PROGRAM
The Philippine Pediatric Society formulated its learning outcomes which are
congruent with the 10 learning outcomes of CHED but with an addition of
community – based practice. Each learning outcome has well defined
competencies.
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Compassionate
responsibility and
accountability to patient
welfare
9. Nationalism and Awareness of global
internationalism health care challenges
Awareness of cultural and
religious diversity
10. Social accountability Knowledge of the
concept of social
Leader/ Manager accountability and its
Social advocate values
Knowledge of the priority
health needs in terms of
pediatrics and the
national objectives for
health of the nation
11. Community – oriented practice Awareness of important
characteristics and needs
of the community that
might impact on patient
care
Application of the
understanding of these
features to improve the
management of the
patient’s population
Awareness of social
determinants of health
Knowledge of resources
available in the
community and effective
use of these resources
Knowledge of the
principles of preventive
pediatric health care
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CHAPTER 4 PROGRAM AND COURSE OUTCOMES OF THE PEDIATRIC RESIDENCY TRAINING
PROGRAM
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treatment-related) abstraction/
problem
10. Educate patient and
presentation
family regarding the
illness/ disorder & its
prognosis Patient’s complete
medical record
11. Formulate health and
wellness plan for Rapport building &
patient and families communication
skills
12. Maintain an accurate
and complete medical Pediatric
record procedures
classified as
13. Refer cases
emergency,
appropriately, i.e.
common or special
subspecialties,
interdepartmental, Attitudes and
social worker, NGOs values espoused
by the institution
and the medical
> In terms of technical
procedural skills: profession
14. Demonstrate mastery
of the common pediatric
procedures
15. Formulate appropriate
and cost-effective
procedure(s) for a
patient for quality
patient care
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PROGRAM COURSE OUTCOMES CONTENT TEACHING- EVALUATION
OUTCOMES LEARNING
ACTIVITIES
2. Develop good Given a clinical situation Specific pediatric Actual patient Performance
communication & in the wards, OPD, clinics health education encounters in rating scale for:
interpersonal or community, the topics to be used specific settings • Preceptorials
skills to convey Pediatric resident-in- during health
information in training should: education Interactive lecture • Bedside
written and oral 1. Explain clearly sessions, family rounds
formats, across relevant information briefing & Plenary/ video
• Clinical
all types of to the patients and debriefing, presentation of
audiences, community trainee performance
their families
venues and assembly, • Community
media in a 2. Listen actively to conferences or Structured ISP
activities
manner that can process information seminars
be easily Lay fora
understood 3. Secure patients’ Health education
cooperation & principles & Community
consent concepts assembly
4. Utilize available
Effective Clinical teaching
forms of
communication activities:
communication skills (verbal and • Preceptorials
5. Make use of non-verbal)
• Bedside rounds
information
Listening skills
technology efficiently
Ethical practice of
medicine
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PROGRAM COURSE OUTCOMES CONTENT TEACHING- EVALUATION
OUTCOMES LEARNING
ACTIVITIES
3.A. Management > In terms of Health programs Preceptorials Performance
skills: Initiate organizational Health facilities rating scale for:
planning, skills: SGDs • Preceptorials
organizing, Given a health program Leadership skills
implementation, to manage/ health Structured • Advocacy
and evaluation of team to lead/ support Management skills ISP project
programs and group to organize, the
health facilities resident-in-training Working in a team Community
Reflection paper
should: work through
3.B. Leadership 1. Assume leadership Programs that address advocacy
Portfolio/
skills: Provide clear roles problems in development projects
Journal
direction, &behavior in families and
inspiration, and 2. Provide clear communities
motivation to the direction,
healthcare inspiration and Advocacy work
team/community motivation to the
team & community Organizing identified
support groups for the
3. Implement the community
program as
planned Project planning,
implementation and
4. Monitor process of
evaluation
the program
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the case/ problem
at hand
9. Develop
competence and
confidence in
decision-making
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4. Create a research
related to the field of
pediatrics following
appropriate research
methodology
6. Reflect on personal
experiences and background
and how these affect team
based learning
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PROGRAM COURSE OUTCOMES CONTENT TEACHING- EVALUATION
OUTCOMES LEARNING
ACTIVITIES
6. Utilize a health The Pediatric resident-in- Systems-based Actual patient Performance
systems-based training should: approach to quality encounters rating scale for:
approach in actual 1. Analyze the health health care • Clinical
delivery of care systems existing in the Preceptorials performance
and in solving hospital, community Health care agencies
pediatric health and the country in the community Community • Community
problems projects work
2. Identify the relevant Health care
health care agencies organizations (GOs & Structured
NGOs) in the country ISP Portfolio/
for children &
journal
adolescents that exist
in the community The principle of
partnership &
3. Utilize systems-based advocacy work
approach in planning,
implementing,
monitoring and
evaluating programs/
advocacy projects for
children & adolescents
4. Advocate for
partnership with other
resources such as GOs
and NGOs to improve
patient care
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PROGRAM COURSE OUTCOMES CONTENT TEACHING- EVALUATION
OUTCOMES LEARNING
ACTIVITIES
7. Value the The Pediatric resident-in- Lectures/ seminars Lectures/ Written exam
importance of training, in order to develop on different topics Seminars
a continuing self-directed lifelong learning, regarding pediatric Performance rating
professional should: health care Scientific scale for:
development 1. Attend lectures/ seminars/ conventions • Preceptorials
through a conventions/ advocacy Conventions and
variety of work related to the field of short structured Preceptorials • Clinical
avenues to training courses on pediatric- competence
ensure quality related health issues E-learning
healthcare 2. Utilize feedback from
Portfolio/ Journal
and patient consultants, hospital staff, Lectures on:
safety pediatrics department staff • Principles of
Reflection paper
and members of the Ethical Practice
community for personal &
• Quality patient
professional growth
care
3. Practice personal reflection
• E-learning
to direct learning with the
aim of improving
knowledge, skills & attitude
to ensure quality health
care & patient safety
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PROGRAM COURSE OUTCOMES CONTENT TEACHING- EVALUATION
OUTCOMES LEARNING
ACTIVITIES
8. Internalize The resident-in-training should Principles of Actual patient Performance rating
Professionalism demonstrate the following Legal Medicine encounters scale for:
by adhering to Professional standards: and Medical • SGD
national and > In terms of adherence to Jurisprudence Preceptorials
international ethical • Preceptorials
codes of conduct and legal principles: Standards for SGDs
• Clinical
and legal 1. Apply ethical and legal trainees of the
competence
standards that standards on all patients PPS Structured
govern the seen without discrimination ISP
medical The Hippocratic
profession 2. Practice the Oath of oath;
Professionals and
Hippocratic oath Principles of
> In terms of compliance to ethical practice
existing laws, rules &
regulations that govern the Code of Ethics of
medical profession: PMA, PPS and
3. Comply with ethical, legal component
and professional standards societies
that the PMA, PPS and
component societies
espouse for the delivery of
health care
4. Uphold the values of the
institution in healthcare
administration, conduct of
researches and provision of
healthcare
> In terms of compassionate
responsibility & accountability
to patient welfare:
5. Demonstrate responsible
citizenship and exhibit
cultural competence in
managing children and their
families
6. Demonstrate
professionalism with co-
learners, academic, non-
academic staff and patients
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PROGRAM COURSE OUTCOMES CONTENT TEACHING- EVALUATION
OUTCOMES LEARNING
ACTIVITIES
9. Demonstrate In any encounter with patients, The Philippine Actual patient Performance
nationalism & co-workers & co-learners, in Culture encounters rating scale for:
internationalism whatever setting, the Pediatric • Preceptorials
through love for resident-in-training should: Principles of Preceptorials
one’s national 1. Practice appropriate attitude ethical • Clinical
heritage, respect & values of a competent and practice Lay fora performance
for other cultures professional health advocate
and commitment with focus on service and Service Community
Journals/
to service love of country oriented work
reflections
curriculum
2. Demonstrate the attributes
Portfolios
of responsible citizenship, Principles of
and cultural competence advocacy work
10. Demonstrate In any encounter with patients, Evidence Actual patient Performance
social co-workers & co-learners, in based encounters rating scale for:
accountability by whatever setting, the Pediatric medicine • Preceptorials
adhering to the resident-in-training should: Preceptorials
principles of 1. Adhere to the principles of E-learning • Clinical
relevance, equity, relevance, equity, quality and Lay fora performance
quality, and cost cost-effectiveness in Clinical
effectiveness in healthcare administration, practice Health
Journals/
the delivery of planning and conduct of guidelines Programs
reflections
healthcare to health projects for children &
patients, families Quality
adolescents Portfolios
and communities assurance
2. Utilize community (public & methods for
private) resources in the delivery of
conduct of health education health care
sessions
Health
3. Recognize the priority health Programs of
needs of the pediatric DOH, WHO,
patients, family and PPS,
community through the use Subspecialty
of evidence-based data and societies and
other health
appropriate technology in
agencies
the delivery of
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comprehensive health care Bioethical
practice of
4. Deliver health care to all medicine
patients regardless of socio-
economic status, political
affiliations, religious beliefs,
ethnicity and gender
Community
health indices
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Community
diagnosis
Principles of
adult learning
Curriculum mapping is a reflective process that helps teachers understand what has been
taught in a class, how it has been taught, and how learning outcomes were assessed. The
curriculum mapping process results in a document known as a curriculum map. Most
curriculum maps are graphical illustrations that consist of a table or matrix. (Karen
Schweitzer , March 2019)
4. Perform thorough PE
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8. Formulate the most appropriate,
patient-centered plan of
management or intervention
(pharmacologic & non-
pharmacologic)
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all types of information
audiences,
venues and 3. Secure patients’ cooperation &
media in a consent
manner that can
4. Utilize available forms of
be easily
communication
understood
5. Make use of information technology
efficiently
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PROGRAM COURSE OUTCOMES YEAR YEAR YEAR
OUTCOMES LEVEL I LEVEL II LEVEL III
4.Demonstrate an > In terms of critical appraisal of evidence: Practice Demonstrate Demonstrate
evidence-based Utilizing various data and information from
practice (or all available resources, the resident-in-
practice-based training should:
learning) through: 1. Utilize evidence-based medicine in the
a. Use of current diagnosis, management, health
research promotion and prevention of pediatric
evidence in diseases/ disorders
decision making
as practitioner, 2. Provide health services to patients,
educator or their families and the community as a
researcher whole using current, acceptable
practice guidelines
b. Participation in
research > In terms of self-assessment & reflection:
3. Regularly reflect on the events
activities
happening in the clinical practice for
improvement/ enhancement of critical
thinking skills
> In terms of production of relevant quality
research:
4. Create a research related to the field of
pediatrics following appropriate research
methodology
5. Practice inter- > In terms of collaboration with other Practice Demonstrate Demonstrate
professionalism by health
effectively working professionals, the Pediatric resident-in-
in teams with co- training should:
physicians and 1. Work effectively with the department
other professionals of pediatrics staff
in managing clients,
institutions, 2. Work effectively, harmoniously and
projects, and similar professionally with peers, faculty and
situations all stakeholders in the hospital &
community in planning,
implementation, monitoring &
evaluation of advocacy projects and
provision of health care for children &
adolescents
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allied health professionals inside and
outside the hospital
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quality health care & patient safety
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heritage, respect values of a competent and
for other cultures professional health advocate with
and commitment focus on service and love of
to service country
2. Demonstrate the attributes of
responsible citizenship, and
cultural competence
3. Exhibit cultural & religious
sensitivity
4. Manifest the attribute of
dedication to service
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patients & their that might impact on patient care
families for
realistic, feasible, 2. Apply the understanding of these
cost effective features to improve the
and relevant management of the practice
service patient’s population
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CHAPTER 6: INSTRUCTIONAL DESIGN
The importance of an Instructional Design (ID) for any teaching-learning encounter is
reiterated. Educators should know its definition, importance, components as well as how to
construct an ID. This chapter highlights concepts pertinent to these factors.
Definition
An ID is a systematic process of planning instruction. It takes into
consideration the variables affecting the teaching-learning process to ensure
successful achievement of learning outcomes set for the particular
instruction.
Importance
With the formulation of an ID, the instruction can be focused on essential
objectives aligned with appropriate assessment methods. It serves as a
teaching guide to faculty members facilitating coordination among team
members and other personnel involved in the teaching-learning process. This
contributes to efficiency in teaching.
Components
I. Learning Objectives
A. Its Significance
All current medical education is objective-based. Achievement of learning is
gauged by acquisition of the objectives of the course. All program evaluators
will be answering the question: Is the program achieving its objectives?
B. Three Elements
1. Performance
• Describes the specific activity that the learner should be able to do upon
completing the learning experience expressed using an action verb that is
observable
• Examples:
1. Identify the signs & symptoms of nephrotic syndrome
2. Perform the EINC on a newborn
3. Respond to a patient’s concern over his chronic illness
2. Standard
• Describes the minimum acceptable level or degree of performance;
describes how well the learner must demonstrate the performance as
evidence that he has learned what was expected of him
• Examples:
o Identify the triad of signs & symptoms of nephrotic syndrome
o Perform the EINC on a newborn with ease
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o Respond to a patient’s concern over his chronic illness such that the
patient appears less anxious
3. Condition
• Describes the specific circumstances under which the performance must be
demonstrated; may refer to the setting, equipment, materials or information
that will be provided to the learner; reflects the test situation
• Examples:
1. Given a list of the signs & symptoms, identify the triad of nephrotic
syndrome
2. In the delivery room setting, perform the EINC on the newborn
3. Given a patient referred for counseling, respond to the concerns on the
chronic illness such that the patient appears less anxious
C. Classification
• Three Domains:
1. Cognitive - focuses on intellectual abilities
2. Psychomotor – focuses on practical skills requiring the use and
coordination of skeletal muscles
3. Affective – focuses on attitudes, values & feelings
(Specific statements of what learners are expected to know, perform, or
feel at the end of instruction)
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Table 1. The different categories of the cognitive process
Level Cognitive Definition Key words (action verbs Sample objectives for
Process which describe the each level
knowledge to be taught Upon completion of the
and measured) Research Module, the
resident should be able
to:
1 Remember Retrieve relevant Define, duplicate, Define “sample” and
knowledge from long identify, list, name, “population”
term memory recall, recognize, relate,
record, repeat,
reproduce, state
2 Understand Construct meaning Choose, cite examples Differentiate between
from instructional of, classify, describe, random and non-
messages, including differentiate between, random sampling
oral, written & discriminate, discuss,
graphic explain, give in own
words, locate
3 Apply Carry out or use a Apply, choose, Given a research
procedure in a given demonstrate, dramatize, problem and target
scenario; use of employ, generalize, population, select the
principles to solve illustrate, interpret, most appropriate
problems; use of initiate, operate, sampling method
learned information operationalize, practice,
in new situations relate, schedule
4 Analyze Break the material Analyze, diagnose, Attribute weaknesses
into constituent parts appraise, calculate, in conclusions made to
and determine how categorize, compare, an error in sampling
parts relate to one contrast, deduce,
another and to an detect, determine,
overall structure or develop, diagram,
purpose; distinguish, draw,
distinguishing & estimate, examine, infer
comprehending
interrelationships
5 Evaluate Make judgments Appraise, assess, argue, Critique a given
based on criteria & critique, defend, judge, sampling method used
standards measure, rate, revise in a given protocol
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Reorganize elements formulate, manage,
into new pattern modify, organize, plan,
prepare, produce,
propose
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6 Adaptation Adaptable proficiency; Adjust, integrate, Adjust to the special
can modify movement solve requirements of a
patterns to fit special patient who has a
requirements chronic illness
7 Origination Creative proficiency; Design, formulate, Design a plan for given
creating new modify, re-design, clinical scenarios which
movement patterns to trouble-shoot are beyond the usual
fit a particular situation
or specific problem
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D. Criteria for Evaluation of the objectives
Always make your objectives SMART: Specific, Measurable, Attainable, Relevant and
Time-bound
IV. RESOURCES
▪ To make the teaching-learning activities interesting & effective
▪ Several factors to consider when selecting media: availability, cost, time to
prepare, simplicity, clarity, maintenance & storage, learner’s and teacher’s
preference; make sure that the instructional media chosen are appropriate to the
learning objective
▪ Examples of instructional media: printed materials (textbooks, study guides,
pamphlets, handouts, monographs); audio-visual aids; models & simulation task
trainers; real objects; standardized patients; actual patients
▪ Support services (budget, facilities, equipment)
V. EVALUATION
▪ Involves finding out how much learning has taken place; the result of which reflect
the amount of learning that has occurred
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▪ A continuous process (done during & at the end of instruction) based on clearly
stated objectives
▪ Make sure that the assessment method used is congruent to the learning domain
to be evaluated
In Pediatric Residency Training, instructional designs may be formulated for the following:
1. For lectures delivered for the trainees on general pediatrics or subspecialty topics
2. For the different rotations as they may be considered the “courses” during the entire
training
Another important consideration is the year level of training which entails different levels of
competencies as well. Research is considered a required competency across all year levels
and should likewise be included.
The format to be followed for a Course Syllabus on the different rotations is shown:
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NAME OF HOSPITAL
DEPARTMENT OF PEDIATRICS
COURSE SYLLABUS FOR _____________ (Specify Rotation)
I. Course information
Course Code: PedWards (if rotation is in the Pedaitrics Ward)
Course Title: Ward rotation for the Pediatric Residency Training Program
(sample only)
Credits/ Hours:
Venue/ setting:
Course Supervisor & Faculty:
IV. Resources
V. Assessment Plan
VI. Course policies (Rules & Regulations)
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CHAPTER 7: TEACHING - LEARNING STRATEGIES
Pediatric residency training in this generation has evolved together with significant changes
in the medical profession. The exponential growth in scientific information and the latest
technologies have changed the landscape for teaching and learning in medicine. The
widespread use of the Internet, cellphones and the social networking phenomenon has also
altered the learning environment. At the same time, attending physicians have acquired
different roles and responsibilities such that bedside teaching with residents has been
reduced significantly.
The key to maximizing learning for the pediatric residents rests on creating a better clinical
learning environment. Evidence suggests that the more effective teaching occurs when the
teaching consultant’s role is to coach and facilitate. This relationship contrasts with the
traditional role of the teaching consultant as the primary source of information and the
evaluator. The responsibility for learning shifts from the consultant to the resident in
training.
Key concepts that need to be observed to make any teaching and learning strategy work for
the new crop of pediatric residents:
1. Identifying the resident as an essential part of the healthcare team has been recognized
as a strong factor in motivating residents to learn. Placing value on the role of the
resident as a partner in the care of patients results to more positive impact on learning.
2. Encouraging the pediatric resident to reflect on their observations and experiences helps
them develop their goal-setting and problem solving abilities.
3. The effective teaching relationship must be grounded on mutual trust. The process of
granting increasing degrees of autonomy in making decisions to the resident establishes
a safe learning environment.
4. The teaching consultants need to be open to innovate ways of teaching the pediatric
residents. They must be encouraged to be curious and search for more knowledge but
need to be assisted in interpreting the information and applying them in the proper
context.
5. Teaching the residents must be brief and concise. There has to be a balance between
time for service to patients and learning. Brief teaching sessions with clear-set objectives
can make the learning process more interesting to the resident and preceptor alike.
6. Providing timely feedback is crucial for the resident’s learning. Both positive and
negative feedback from trainor to trainee are necessary but must be preceded by a
respectful trainor-trainee relationship. Communicating timelines and expected outcomes
for tasks will also be helpful to minimize confusion.
7. The patient must remain at the center of all learning opportunities. Highlighting the
centrality of the patient is essential and the preceptor must find ways to provide context
and connect the learning experience to the patient.
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Popular approaches for teaching pediatric residents may be adapted:
A. The One-Minute Preceptor
This strategy is a structured framework for clinical teaching that can be accomplished
within a few minutes. This model uses a five-step approach:
SNAPPS:
This strategy with a six-step mnemonic is another learner-centered model that is
often applied in the outpatient setting. In this model, the resident presents the
patient’s case summary to a preceptor followed by five steps that require clinical
reasoning and discussion.
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2. Narrow the differential to two or three relevant possibilities
The resident verbalizes what he or she thinks is going on in the case, focusing
on the most likely possibilities. For follow-up or sick visits, the differential may
focus on why the patient’s disease is active, what therapeutic interventions
might be considered, or relevant preventive health strategies. This step
requires a commitment on the part of the resident similar to the OMP model
of clinical teaching.
C. Bedside Teaching
Teaching at the bedside provides a great opportunity for the attending pediatrician
to diagnose the patient, “diagnose” the resident and teach at the same time. Thus
this method of teaching should not be removed among the teaching and learning
strategies for pediatric residents. Studies have shown that if done properly, the
bedside teaching can foster a stronger patient-physician bond. Selection of patients
may also be observed according to factors that may affect the health team workflow,
the trainees’ learning needs and clinical requirements as seen in Table 1.
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Table 1. Prioritization of patients chosen for and deferred from bedside rounds
Definitely perform bedside rounds Sick patients requiring immediate care
New admissions to team
Post-call days
Likely to perform bedside rounds Clinical-decision making required
High educational value for trainees
Geographic considerations
Variable (depending on time Patients pending discharge
and patient census) House staff preference
Likely to defer bedside rounds Clinically stable patients with low educational value
Sensitive issues anticipated in discussion
Patient on contact or respiratory isolation
Definitely defer bedside rounds Patient not available (e.g. off floor for testing)
Patient status impairs adequate communication (e.g. if
obtunded)
Unwilling patient
*Reference: Gonzalo, JD, Heist, BS, Duffy, BL, Dyrbye, L, Fagan, MJ, et.al., (2012). The art of bedside rounds: A multi-center
qualitative study of strategies used by experienced bedside teachers. J Gen Intern Med. 28(3):412–20.
Although bedside teaching may seem like a complex strategy for teaching, observing the
following steps will help make it a valuable learning experience for the residents:
1. Meet as a team before rounding the patient.
2. Review the chart first and have a resident give an oral presentation of the patient’s
case.
3. As the patient is approached, the preceptor must role-model the proper bedside
behavior to the team. All members of the team must be introduced to the patient and
permission to perform bedside round must be obtained from the patient. It is
imperative to explain to the patient how the bedside teaching will be done and ensure
that the patient is comfortable all throughout the teaching round.
4. The bedside evaluation may entail asking more questions for additional details of the
patient’s history or to examine the patient.
5. Before leaving the patient, make sure that the patient’s own questions or concerns
have been addressed and the patient remains comfortable.
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CHAPTER 8. ASSESSMENT & EVALUATION OF RESIDENTS
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Areas, Methods and Tools used for Assessment & Evaluation
1. List the objectives or content areas on the first left hand column of the table.
2. Determine the weights (number of test questions or % for each content area)
3. Decide on a second dimension to constitute the other column in the table. (Recall,
comprehension, application)
4. Determine the number of test questions or % for each item in the second dimension.
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Example: Intestinal Obstruction in Children
Objectives
Diagnosis 70% 0 0 10 15 10 0
(35 items)
Management 30% 0 0 0 10 5 0
(15 items)
Total items 0 0 10 25 15 0
per category
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EXERCISE #4: CONSTRUCT A TEST BLUEPRINT OF THE TOPIC YOU WILL LECTURE
Topic: _________________________
Year of Resident: ________________
Total number of items: ___________
Steps to follow:
1. List the constructs (whether as objectives or content areas) on the first left hand
column of the table
1___________________________________
2.___________________________________
3. Etc. ______________________________
2. Determine the weights (number of test questions or % for each content area)
3. Distribute the items according to the appropriate categories of the cognitive domain
(remember, understand, apply, analyze, evaluate, create)
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References:
Harden, Ronald M. Essential Skills for Medical Teacher 2nd edition
Sana, Erlyn, A. Teaching and Learning in Health Sciences
Spady, Willimas. 1994. Outcome Based Education: Critical Issues and Answers
Gonzalo, JD, Heist, BS, Duffy, BL, Dyrbye, L, Fagan, MJ, et.al., (2012). The art of bedside
rounds: A multi-center qualitative study of strategies used by experienced bedside teachers.
J Gen Intern Med. 28(3):412–20
Mookherjee, S. & Cosgrove, EM. (ed). (2016). Handbook of Clinical Teaching. Springer
International Publishing. Kindle Edition.
Neher, JO, Gordon, KC, Meyer, B, & Stevens, N. (1992). A five-step “microskills” model of
clinical teaching. J Am Board Fam Pract. 5: 419-424.
Ten Cate, O. & Peters, M. (2014). Bedside teaching in medical education: a literature review.
3:76-88. Perspect Med Educ. 3: 76-88.
Wolpaw, TM, Wolpaw, DR, & Papp, KK. (2003). SNAPPS: A learner-centered model for
outpatient education. Academic Medicine. 78(9): 893-898.
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APPENDIX A1
NAME OF HOSPITAL
DEPARTMENT OF PEDIATRICS
PEDIATRIC RESIDENCY TRAINING PROGRAM CURRICULUM IN OUTCOME-BASED DESIGN
I. Course information
Course Code: PedWards
Course Title: Clinical ward rotation in Pediatric Residency Training Program
Credits/Months of rotation: As recommended by the Hospital Accreditation Board of
the Philippine Pediatric Society
Venue/Setting: Pediatric wards
Write full name of hospital including address
Course Supervisor and Faculty: Consultant-of –the month
A. Year level 1
As early as Year Level 1 residency training, the residents rotating in the
pediatric wards are expected to master the diagnosis and management of
the common pediatric illnesses/ conditions in the national or international
level. They will be trained to be knowledgeable on all the aspects of pediatric
illnesses including the epidemiology, incidence, pathophysiology, clinical
manifestations, diagnosis, differential diagnosis, treatment, complications,
prognosis and preventive measures. This is in terms of the learning outcome
on clinical competence. Actual patient encounters would develop their good
communications skills, rapport building, ethical practice of medicine and their
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dedication to service. Team work with co-residents, students and other
members of the team caring for the patients would enhance their
professionalism, inter-professionalism as well as teaching skills. Networking
with other hospitals, clinics, health centers, support groups for a
comprehensive, long term management for a patient is likewise developed
during the ward rotation. Acquisition of basic procedural skills as well as
proper attitude is given equal importance.
B. Year level 2
During the Year Level 2 clinical ward rotation, the residents are expected to
master not only the common but as well as the more complex pediatric
conditions. They should perform not only the basic procedural skills but the
complex pediatric procedures such as thoracentesis, intubation, exchange
transfusion, lumbar puncture, among others. Greater responsibility in terms of
teaching junior residents as well as medical students are also given to 2nd year
residents. Greater administrative duties are also entrusted to them to train
them to be good managers and social mobilizers.
C. Year Level 3
The 3rd year pediatric residents-in-training are expected to comprehensively
diagnose and initially manage uncommon, chronic and complicated pediatric
conditions, aside from the mastery of the common and complicated cases.
Management of the more common subspecialty cases are included in their
learning outcomes. In addition, the more complex pediatric procedures such as
CVP insertion and cutdown are additional skills they need to perform.
Teaching skills are highlighted during this year which includes bedside rounds,
preceptorials and must know lectures to the rotating medical students, junior
residents and other health care providers included in the team. Planning and
implementation of community outreach projects for social accountability to
the community is one of the learning outcomes that is emphasized during the
last year of training.
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III. Instructional Design
Year Level 1:
At the end of the 1st year of pediatric residency training, the resident rotating in the pediatrics wards is expected to perform
the following learning outcomes during actual patient encounters:
1. Diagnose the Pediatric history taking; ▪ Actual Minimum of 6 Written exam &
more patient months cumulative quizzes;
common Pediatric PE; encounte rotation at the
pediatric rs wards for the Oral examination;
Common pediatric
illnesses/ entire 1st year of
disorders/ illnesses ▪ Monthly Performance rating
disorders training
staff scale for:
(See Core Pediatrics for the
(LO1, LO2, LO4) lectures (remaining 4
list) to include: • Clinical
months for ER/OPD
▪ Monthly performance
▪ Epidemiology rotation and 2
audit/ months for NICU • Bedside rounds
▪ Pathophysiolog Mortality rotation)
y review • Preceptorials
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(LO1, LO2, LO4, LO5) Referrals needed
Complications
Preventive measures
f. Intraosseous infusion
g. NGT insertion
h. Lumbar puncture
i. Umbilical
catheterization
j. Specimen collection
and handling
l. BLS
m. PALS
n. NRP
Indications, procedural
steps, precautions,
complications of these
procedures
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management workplace • Lay fora • Preceptorials
of patients in
and outside • Preceptorials • Community
the hospital project
Advocacy work
including the
community
(LO5, LO8)
(LO6, LO10)
▪ presentations
during the required
departmental
conferences
▪ self-study habits
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medical Clinical teaching skills • Mentoring tool with
interns rubrics
• Role playing
(LO1, LO2, LO4, LO7)
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4. Umbilical catherization • Preceptorials
5. Exchange Transfusion • Mentoring
6. Intraosseous infusion
7. Suprapubic urine
collection
8. Paracentesis
9. Emergency needling
4. Lead pediatric Application of BLS/ PALS/ • Actual patient Observation
resuscitation NRP trainings encounters Checklist for the
measures procedures
(LO1, LO2, LO3,
LO5)
5. Manage a health More extensive delivery • SGD Perforamance rating
care team of leadership & • Community scale for:
(LO1, LO2, LO3, management skills; projects • Clinical
LO5, LO6, LO9, Organizing communities • Lay fora performance
LO10) for health –related • Preceptorials • Preceptorials
activities • Community
project
Year Level 3
At the end of the 3rd year of training, with a 4 month cumulative period, the resident rotating in the pediatric
wards is expected to perform with excellence & mastery all of the learning outcomes for 1 st year and 2nd year
residents PLUS:
1. Diagnose Uncommon, chronic & • Actual patient Minimum of 3 Written exam &
uncommon, complicated pediatric encounters months quizzes;
chronic & conditions as to its: • Monthly staff cumulative Oral examination;
complicated a. Epidemiology lectures rotation at the Performance rating
pediatric b. Pathophysiology • Monthly audit/ wards for the scale for:
conditions c. Clinical manifestations Mortality entire 3rd year of • Clinical
(LO1, LO2, LO4) d. Differentials training performance
review
e. Diagnosis
• Monthly (remaining 2 • Bedside rounds
f. Diagnostics/
clinicodiagnostic subspecialty months for ER/OPD, • Preceptorials
hour 2 months NICU, 4 • Conferences
correlation
months for
g. Prognosis • Daily rounds (audits,
subspecialty/
(Appendix A3: List of • Mentoring electives/ outside
subspecialty
uncommon, chronic & • Preceptorials rotation, and 1 lectures/
complicated pediatric • Bedside rounds month community) presentations,
conditions) etc)
Mini-CEX
2. Manage these Treatment plan
complex ▪ Therapeutic/
conditions Pharmacologic
appropriately ▪ Surgical
(LO1, LO2, LO4, ▪ Supportive/
Rehabilitative
LO5)
Referrals needed
Complications
Preventive measures
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3. Perform more a. CVP insertion • Demonstration/ Observation
complex b. Cut down Return checklist for the
pediatric demonstration procedures
procedures • Actual patient
(LO1, LO2) encounters
V. Evaluation plan
Sample:
Clinical performance in the wards comprise the majority of the grade of each
resident comprising _____% of the over-all grade as can be seen in the following
grading scheme:
Clinical performance =
Written exam =
Practical/ oral exam/ OSCE =
Research =
______________
Total = 100%
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APPENDIX A2
NAME OF HOSPITAL
DEPARTMENT OF PEDIATRICS
PEDIATRIC RESIDENCY TRAINING PROGRAM CURRICULUM IN OUTCOME-BASED DESIGN
I. Course information
Course Code: PedResearch
Course Title: Research in Pediatric Residency Training Program
Credits/Hours: Process covers entire years of residency training in pediatrics
Venue/Setting:
Course Supervisor and Faculty:
B. Year level 2
The Year Level II residency training in research focuses on the skills in writing a
research proposal. Understanding the parts of a research will translate to a correctly
written research manuscript. Entry competency includes an approved research
question and well written review of related literature. Terminal competencies include
understanding of ethical issues in conducting research, mastery of research
methodology, statistical methods and sampling methods.
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C. Year Level 3
The Year Level III residency training in research focuses on the actual conduct of the
research proposal. Time management with regards research activities is important.
Entry competency includes a research proposal duly approved by the IRB. Terminal
competencies include a final manuscript written in the prescribed format and
presentation of the finished research project in an appropriate forum.
Year Level 1
At the end of the 1st year of training, the resident is expected to perform the following specific steps for
Learning Outcome 3 - Engage in research activities:
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department staff
Journals/ articles;
▪ Formulatin
ga
research
hypothesis
Year Level 2
At the end of the 2nd year of training, the resident is expected to perform the following specific steps for
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Learning Outcome 3 - Engage in research activities, as a continuum from YL1:
Year Level 3
At the end of the 3rd year of training, the resident is expected to perform the following specific steps for
Learning Outcome 3 - Engage in research activities, as a continuum from YL2:
Prescribed research
3. Present the Research presentation 10th to 12
format;
final month of 3rd
research Prescribed format for year
output audio-visual presentation residency
of the research
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IV. Course Resources
A. References: textbooks, handbooks, updated journals, e-books, PPS Clinical
Practice Guidelines; websites
B. Equipment: medical or departmental library with updated references and
webpages especially for literature search, computers/ laptops
C. Human resources: Consultant mentors, epidemiologists, research experts for
proper guidance during the entire conduct of the research
D. Administrative support: logistics for the conduct of the research, research
funds
V. Evaluation plan
Sample:
Research in the pediatric residency training comprise ____ % of the over-all grade
of the resident as can be seen in the following grading scheme:
Clinical performance =
Written exam =
Practical/ oral exam/ OSCE =
Research =
______________
Total = 100%
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