Course syllabus for Clinical medicine 5: Pediatric and adolescent medicine
Klinisk medicin 5: Barn- och ungdomsmedicin
Essential data
Specific entry requirements
A passing grade is required in the following courses:
- Basic Science 1–6, Medical diagnostics integrated with basic science, Medical scientific theory and methodology, Clinical Medicine 1–3, and Degree Project in Medicine (semesters 1–8)
- The course components “Neurology and Rehabilitation Medicine,” “Psychiatry and Addiction Medicine,” and “Ophthalmology and Otorhinolaryngology from the course Clinical Medicine 4: Neuro, senses and psyche.
A student who has failed clinical placement (VFU) or equivalent due to serious deficiencies in knowledge, skills, or professional conduct that have jeopardized patient safety or public trust in healthcare, is eligible for a new clinical placement opportunity only once the individual action plan has been completed.
Outcomes
The overall aim of the course is for students to acquire the knowledge, skills and approach necessary to diagnose and manage common and serious pediatric and adolescent medicine, pediatric and adolescent psychiatry, pediatric surgical and genetic diseases in a safe and professional manner.
The course also includes scientific, global, health promotion and equal opportunity perspectives. Knowledge, skills and practical application of the physician role in the healthcare team are based on evidence-based treatment and person-centered care and supervised clinical training with feedback. Skills training follows a progression model aligned with the nationally agreed framework of Entrustable Professional Activities (EPA).
Learning outcomes
The intended learning outcomes of the course are aligned with the national learning objectives for the medical degree as stated in the Swedish Higher Education Ordinance (SFS 1993:100). Learning outcomes related to knowledge and understanding are categorized according to the SOLO taxonomy (S2–S5), and those related to skills and abilities are categorized according to Miller’s pyramid (M3–M4)
Knowledge and understanding
To pass the course, the student must be able to:
- conduct a differential diagnosis regarding the treatment of common, acute, and serious medical conditions in children and adolescents based on medical history, symptoms and clinical findings and determine the appropriate level of care in general medicine and pediatric healthcare. (S4)
- describe basic principles for assessing the growth of children and adolescents, identify deviations from this and if necessary, identify appropriate pediatric medical investigations (S4)
- describe physiological differences between children of different ages and adults, including the transition at birth and explain important differences between children, adolescents and adults in terms of medical and surgical assessments (S3)
- describe the normal psychomotor, cognitive, social and emotional development of children and adolescents, as well as common and serious developmental abnormalities (S4)
- analyze the significance of psychological and social factors, such as gender, socioeconomic conditions, migration background and violence in close relationships when assessing medical and surgical conditions in children and adolescents (S4)
- describe health promotion initiatives for equal health at the population level locally and globally, with focus on child health centers and school health care, as well as support for healthy lifestyles at the individual and family level among newborns, children, and adolescents (S3).
- identify suspected violence against children and adolescents and describe principles for meeting, managing and follow-up (S4)
- explain basic principles of pharmacokinetics and pharmacodynamics related to growing children/adolescents and indicate sources of drug information (S4)
- explain how somatic and psychological symptoms can indicate child and adolescent psychiatric conditions and what information is needed to be able to draw up an initial investigation plan, assess the level of care required and set diagnosis (S4)
- discuss specific factors of significance for child and adolescent psychiatric symptomatology and treatment in individual cases, based on a biopsychosocial holistic perspective and the child's maturity and level of development (S4)
- describe appropriate initial measures for common, serious and acute child and adolescent psychiatric conditions and describe appropriate treatment options (S3)
- describe interprofessional teamwork in child and adolescent psychiatry, as well as the importance of collaboration with close healthcare providers and other community actors at different levels of care (S3)
- describe the global burden of disease for children and adolescents, analyze the impact of social and economic factors on health outcomes and inequalities in children's health, globally and locally, and relate this to the Convention on the Rights of the Child (S4)
- explain when a genetic disease should be suspected and when consultation with clinical genetics expertise is necessary and describe the principles of investigation and management of patients and families with congenital or acquired genetic diseases (S4)
- describe the molecular background of genetic abnormalities in congenital and acquired genetic diseases and describe genetic prenatal diagnostic methods and their clinical application (S4).
Competence and skills
To pass the course, the student must be able to:
- take a medical history and perform a physical examination in an age-appropriate manner and assess, manage and document common, acute and serious conditions in children and adolescents (M4)
- demonstrate the ability to independently diagnose and initiate treatment of acute conditions in children and adolescents (M4)
- evaluate findings from medical, pathophysiological and ethical perspectives and be able to explain these to patients and their families (M4)
- apply relevant regulations, laws and conventions concerning the rights and well-being of children and adolescents (M3)
- meet patients and guardians with a deep professional approach and with respect for their integrity, needs, knowledge and experiences (M4)
- be able to collaborate and lead interprofessionally in healthcare (M3)
- prescribe medication taking into account the child's condition, age and weight (M3)
- construct and analyze a pedigree (M3)
- perform risk calculations for monogenic conditions and assess the risk of recurrence in cases of chromosomal abnormalities and multifactorial diseases (M3)
- describe the investigation process in a clinical genetic investigation and communicate this to the patient and their families (M3)
Judgement and approach
To pass the course, the student must be able to:
- take active responsibility for their learning and professional development and be able to reflect on their own limitations
- demonstrate an ability to take a person-centered and health-promoting approach with a holistic view of the patient.
- value the genetic counseling situation and its ethical aspects
- consider how a genetic diagnosis in one individual may affect other individuals in the family
- act and behave appropriately and professionally in clinical and other learning situations.
Content
The course covers the specialties of pediatrics and adolescent medicine, pediatric surgery, child and adolescent psychiatry, clinical genetics and builds on basic scientific and clinical knowledge and skills from previous courses. Interprofessional learning is a central part of the course in order to prepare students for their future professional roles.
The course is divided into six modules:
Pediatric and adolescent medicine and pediatric surgery, 4 credits
The module focuses on the fields of pediatric and adolescent medicine, pediatric surgery, pediatric urology and pediatric orthopedics as well as general medical perspectives relevant to these areas. Normal growth and development in children, deviations from this and pathology are covered in the module. Health promotion work and the vulnerability of children and adolescents in the family, close relationships and society, as well as regulations and laws to support and investigate children and adolescents who are vulnerable are highlighted. It is taught in the form of a theme day together with the course Clinical Medicine 6: Obstetrics and Gynaecology. Knowledge of care levels and care planning is included. Great importance is focused on understanding and meeting children and adolescents of different ages and their guardians, as well as understanding the differences between children and adults in terms of physiology and various pediatric medical and surgical conditions. The course covers knowledge about the global burden of disease for children and adolescents, with an emphasis on the most important challenges in child health and how children's health is affected by the global sustainability goals and the Convention on the Rights of the Child. Social and economic conditions and the impact of migration on health outcomes and inequality in children's health, globally and locally, are highlighted.
The teaching includes both theory and practical exercises, including simulation.
Child- and adolescent psychiatry, 1,5 credits
This module covers the subject area of child and adolescent psychiatry and builds on the introduction included in the course Clinical medicine 4: Neuro, senses and psyche. Normal psychological development and deviations from this are highlighted, as are health promotion efforts and the importance of early identification of psychiatric disorders in children and adolescents.
The course covers child and adolescent psychiatry with an emphasis on common conditions, serious conditions and assessment of suicide risk. Relevant legislation is highlighted, particularly regarding compulsory psychiatric care and social services. A key aspect is the ability to apply a holistic perspective in clinical work, which includes collaboration with the family and network. In addition, the importance of considering a biopsychosocial developmental perspective in ethical and medical decisions is emphasized.
Clinical genetics, 1,5 credits
The clinical genetics module covers knowledge and skills needed to identify clinical situations where genetic diagnostics or expertise are required to manage patients. Great emphasis is placed on the clinical genetic investigation process and the consequences for both the individual and the family, as well as principles for managing common genetic diseases, including hereditary cancer. Students are given the opportunity to reflect on and discuss ethical and legal aspects and issues associated with genetic testing, genetic counseling and prenatal diagnosis.
Clinical placement, 6 credits
The student conducts clinical placement (VFU) in pediatric and adolescent medicine and pediatric surgery.
Placements are in inpatient wards, emergency departments, specialist clinics and outpatient clinics. During the clinical placement, students are given the opportunity to apply and broaden their previously acquired skills from a pediatric and adolescent medicine and pediatric surgery perspective. Students practice reasoning on differential diagnosis based on symptoms and findings by applying basic scientific and pathophysiological explanatory models, as well as meeting patients and guardians in a professional manner.
The placement aims to enable students to acquire the knowledge, skills and attitudes needed to work as a licensed physician and primarily take care of and when necessary, refer children and adolescents in outpatient care and emergency care.
Examination (grading) of professional conduct in clinical placements is carried out through continuous assessment based on the program's criteria.
Professionalism, responsibility and learning, 0.5 credits
Teaching, training and assessment of a professional conduct, responsibility and learning take place continuously throughout the course and specifically addressed during Team-Based Learning (TBL) sessions and the Mentor Program and the final assignment with reflection on the student's own learning in relation to the course's learning objectives.
The mentoring program relates to other teaching in the course with the aim of supporting students' personal and professional development. Based on the CanMEDS framework, students together with their mentor, are given the opportunity to reflect on their development in relation to the learning objectives of the program, documented performance in their portfolio and their future professional role as a physician.
Examination (grading) of professional conduct outside of clinical placement takes place in this module*, through continuous assessment based on the program's criteria.
Professional conduct in authentic clinical situations is not assessed and graded in this module, but in the clinical placement (VFU) module.
Application and integration, 1,5 credits
The module includes repetition and integration through self-study, skills training and a written examination. The written examination covers pediatric and adolescent medicine as well as pediatric surgery. During the clinical placement, formative assessments of the student's clinical competence and professional approach are carried out. A summative assessment in the form of a practical exam (sit-in) is carried out.
Teaching methods
The course includes work-integrated learning (VIL), which combines theoretical education and clinical placement (VFU). The theoretical part is mainly conducted through seminars and team-based learning (TBL). It also includes lectures, digital presentations, simulations, workshops, skills training, self-study, and a theme day together with the course Clinical Medicine 6: Obstetrics and Gynaecology.
Examination
Pediatric and adolescent medicine and pediatric surgery, 4 credits
Examination
- Written examination (digital quiz)
Mandatory participation
- Seminars
- Workshops
- Team-based learning (TBL)
- Simulations
- Skills training
Child- and adolescent psychiatry, 1,5 credits
Examination
- Written examination
Mandatory participation
- Three digital quizzes
- Seminars
- Skills training (digital training in suicide prevention)
- Skills training (digital education in mental health)
Clinical genetics, 1,5 credits
Examination
- Written examination
- Oral examination: oral presentation at an examination seminar
Mandatory participation
- Seminars (case presentation)
- Workshops
Clinical placement, 6 credits
Examination
- Examination in clinical placements (VFU)**
Mandatory participation
- Clinical placements (VFU) and work-integrated learning (VIL)
Mandatory formative assessments
- Continuous assessment during clinical placements (VFU)*
Professionalism, responsibility and learning, 0.5 credits* *
Mandatory participation
- The mentoring programme
Mandatory formative assessments
- Self-assessment and individual work plan (mentoring program)
- Self-assessment and peer evaluation in TBL
- Written assignment (TBL team's agreed working method)
Examination
- Assessment of professional conduct*
Application and integration, 1,5 credits
Examination
- Practical exam in the form of a sit-in
- Written examination
To participate in the written examination, students must have passed all mandatory activities during the course including the clinical placement. To be admitted to the practical examination, Sit-in, students must have completed 50% of the clinical placement.
* The learning objectives related to professionalism are continuously assessed, based on established criteria, in all contexts where the student acts in their role as a student or participates in activities related to the university or healthcare services, including communication and digital media. If a lack of goal fulfillment is identified (based on relevant documentation), the examiner may fail the student in the module Professionalism, responsibility and learning (PFAL) or in the clinical placement module, if the deficiency occurs during clinical training. In such cases, an individual action plan must be established.
Students are entitled to two examination attempts for the assessment of professional conduct in both PFAL and clinical placement. A failed assessment of professional conduct during clinical placement counts as one used examination attempt. Re-examination requires the student to retake the entire module, supported by the action plan. Re-examination of a failed PFAL module takes place during a subsequent course as specified in the action plan.
**) Examination in clinical placement is summative and based on repeated formative assessments conducted during clinical training. These assessments are documented using validated tools such as MiniCEX, MSF, DOPS, EPA, or structured dialogue instruments.
The examiner decides whether and how absence from mandatory course elements can be compensated. Before the student has participated in the mandatory elements or made up for absence in accordance with the examiner’s instructions, the study results cannot be finalized. Absence from a mandatory element may mean that the student cannot make up the occasion until the next time the course is given.
The examiner may immediately terminate a student’s clinical placement (VFU) if the student demonstrates such serious deficiencies in knowledge, skills or professional conduct that patient safety or public trust in healthcare is at risk. In such cases, the student will fail the module and one attempt will be considered used. An individual action plan must then be established, outlining the activities and assessments required before the student may resume clinical training in the course. If the termination is due to serious deficiencies in professional conduct outside of clinical placement, the student will fail the PFAL module and one examination attempt will be considered used. The student may not participate in any further course activities until an action plan has been established.
Students who do not pass the regular examinations are entitled to five additional examination attempts. After six failed attempts at the same examination, no further attempts will be granted. Each participation in the same examination counts as one attempt. Submitting a blank exam counts as an attempt. Registering for but not attending an exam does not count as an attempt. For clinical placement assessments (VFU), students are entitled to two examination attempts.
If there are special circumstances or if the student has a documented disability, the examiner may decide to deviate from the course syllabus regarding the form of examination, number of examination attempts, opportunities for supplementary work or exemptions from mandatory components. However, the content, learning objectives, and required level of knowledge, skills, and abilities must not be altered, removed, or lowered.
To take an examination scheduled for a different course instance than the one the student is registered for, the student must have attempted the corresponding examination during their original course instance or have had valid reasons for not attending.
Other directives
Language of instruction
The language of instruction is Swedish, but some teaching may be in English. The second course instance in the spring semester is an international course and all teaching is given in English. Swedish and English literature is used in the course.
**Learning portfolio **
Support for the student’s development across various competency areas is continuously documented in the student’s individual learning portfolio. The responsible department provides information on which documents should be retained for the current course instance.
Scheduling
Course activities may be scheduled during evenings and weekends.
**Course evaluation **
Course evaluations are conducted in accordance with the guidelines of Karolinska Institutet.
Literature and other teaching aids
Mandatory litterature – one of the following
**Pediatrik **Moëll, Christian; Gustafsson, Jan
2:a upplagan : Stockholm : Liber, 2017 - 627 sidor ISBN:9789147112968 LIBRIS-ID:21139754 Sök i biblioteket
Illustrated textbook of paediatricsLissauer, Tom; Carroll, Will
Sixth edition : Elsevier, [2022] - 593 sidor ISBN:9780702081804 LIBRIS-ID:7lvn7h7x59jj1zzv URL: Länk Sök i biblioteket
**Barnmedicin **Hanséus, Katarina; Jägervall, Martin; Norman, Mikael
5 uppl. : Studentlitteratur AB, 2020 - 914 sidor ISBN:9789144129563 LIBRIS-ID:dqcngst5bbf77xdx Sök i biblioteket
Recommended literature and other teaching aids
**Akut pediatrik **Norgren, Svante; Ludvigsson, Jonas; Norman, Mikael
Åttonde upplagan : Stockholm : Liber, [2019] - 454 sidor ISBN:9789147114276 LIBRIS-ID:6hcdb3t547nrlll2 Sök i biblioteket
Kompendium i barnkirurgi och barnortopediFrenckner, Björn; Hirsch, Georg; Wester, Tomas; Åstrand, Per
[Ny, omarb. och uppdaterad utg.] : Stockholm : Karolinska Institutet University Press, 2015 - 388 s. ISBN:9789185565764 LIBRIS-ID:17592866 Sök i biblioteket
Nelson essentials of pediatricsMarcdante, Karen J.; Kliegman, Robert; Schuh, Abigail M.
9 edition : Philadelphia, PA : Elsevier, [2023] - xv, 829 pages ISBN:9780323775625 LIBRIS-ID:v9gdpfs7sbqjgzq2 Sök i biblioteket
**Psykiatri **Herlofson J., Ekselius L., & Åsberg M. red.
Upplaga 3:1. Lund: Studentlitteratur, 2024 – 704 sidor ISBN: 978-91-44-19089-1
Kap 17 Psykiska problem med debut i barndomen, s 175–192 samt Kap 18 Intellektuell funktionsnedsättning (utvecklingsstörning) och psykisk ohälsa, s 201–212
Kliniska riktlinjer; Svenska föreningen för barn- och ungdomspsykiatri
URL: Svenska föreningen för barn- och ungdomspsykiatri
Kunskapsstöd för vårdgivare; Suicidnära barn och ungdomar
Region Stockholm, 2020 URL: Länk
Clinical genetics
Recommended literature and other teaching aids
Genetiska sjukdomarNordenskjöld, Magnus
2. uppl. : Stockholm : Liber, 2024 - 352 s. ISBN: 978-91-47-14829-5 Sök i biblioteket
Read, Andrew P.; Donnai, Dian New clinical genetics
2. ed. : Oxfordshire, UK : Scion, 2011 - xvii, 442 s. ISBN:978-1-904842-80-4 LIBRIS-ID:12071084 This book may be borrowed from the course administration for international students Sök i biblioteket
In addition, course materials, including references to current scientific publications, are provided on the learning platform.