Header Child Neurology

Child Neurology Residency

Headache Clinic

Patient Care

Goals

Excellent training and exposure to various headache and pain syndromes and appropriate management techniques.

Objectives

Residents will:

Learn and develop skills in diagnosis and management of patients with headache syndromes. The supervising attending physicians will evaluate clinical competence at the end of the rotation in the electronic evaluation.

Medical Knowledge

Goals

Aacquire knowledge in different aspects of the headache medicine through background reading, review of the relevant literature in the course of evaluation of specific patients, and interaction with the Headache clinic staff physicians.

Objectives

Residents will:

  1. Be able to identify, properly classify, and understand treatment approaches to primary headache disorders.
    • Migraine (with and without aura)
    • Tension-type headache
    • Cluster headache and other trigeminal autonomic cephalgias.
  2. Be able to identify history and physical exam red flags that are characteristic of secondary headache disorders, and the appropriate steps to evaluate these headaches.
  3. Be able to identify chronic daily headache syndromes, and establish appropriate treatment plans for management of these syndromes including:
    • Medication overuse headache
    • Transformed chronic migraine
    • Chronic tension-type headache
    • Hemicrania continua
    • New daily persistent headache (NDPH).
  4. Be able to identify situations in which neuroimaging and diagnostic testing is warranted for headache evaluation.
  5. Be able to identify treatment approaches available for status migrainosus.
  6. Understand the indications, risks and benefits, side effects, and monitoring required for commonly used headache medications, including but not limited to:
    • Beta Blockers
    • Tricyclic antidepressants
    • Antiepileptic medications including topiramate, valproic acid, and gabapentin
    • Calcium channel blockers
    • NSAIDS
    • Combination abortive medications
    • Triptans
    • SSRIs
    • Supplements/Herbals including magnesium, riboflavin, Co-enzyme Q10, feverfew, and butterbur.
  7. Be able to identify indications for re-evaluation of patient with a chronic history of headaches.
  8. Gain exposure to alternative treatments for headaches, including chemodenervation, trigger point injections, physical therapy, and cognitive behavioral therapy.

Practice-based Learning and Improvement

Goals

Identify opportunities for improvement in the delivery of quality of patient care.

Objectives

Residents will:

  1. Log patient encounters in the resident Patient Log for review with the Program Director.
  2. Review learning and improvement goals through frequent feedback from staff physicians working with them. Incorporate all available learning sources, including information technology to optimize their learning of all aspects of headache treatment.

Interpersonal and Communications Skills

Goals

  1. Residents will become skillful listeners, and develop specific proficiency in communicating with patients with headache syndromes.
  2. Residents will learn to communicate rapidly and efficiently with other team members in order to ensure that proper therapies can be provided in a timely manner.
  3. Residents will learn to clearly communicate neurological assessments and plans to patients, their families, and members of the multidisciplinary care team.

Objectives

Residents will:

  1. Demonstrate professional, effective interpersonal and communication skills when communicating with supervising physicians, other health care providers, patients and families.
  2. Maintain comprehensive and timely medical records.
  3. Develop their communication skills through periodic assessments with supervising staff physicians.

Professionalism

Goals

  1. The resident demonstrates integrity, honesty and compassion, empathy and altruism.
  2. The resident acknowledges errors and limitations.
  3. The resident demonstrates responsibility, accountability, dependability, commitment and encourages continuity of care.
  4. The resident exhibits respect for all persons regardless of their cultural, ethnic, religious, and socioeconomic background.
  5. The resident exhibits a commitment to the development of cultural humility.
  6. The resident complies with the regulations set forth by the University of Wisconsin Hospital and Clinics including all training sites.
  7. Any breaches in professionalism that occur are met with remorse on the part of the resident. Furthermore, it is expected that the resident will use such breaches as lessons to prevent similar problems in the future.

Objectives

Residents will demonstrate compassion, integrity, patient privacy and be respectful for patients, their colleagues and other health care providers. Competence in professionalism will be assessed by supervising staff physicians.

System-based Practice

Goals

The resident recognizes that he/she is part of a large and intricate health system that has implications for his/her ability to care for patients and impacts upon his/her patients’ human needs and financial resources.

Objectives

Residents will:

  1. Coordinate optimal diagnostic evaluations and patient management with cost awareness within the available health care delivery systems.
  2. Learn to utilize available resources for patients with headaches.
  3. Advocate for quality patient care and work with other health care professionals to enhance patient safety. Competence in system-based medicine will be evaluated by staff physicians.
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