Pediatric Neurocritical Care: Onset to Outcomes (KISC)

2 units

Effective delivery of pediatric neurocritical care (PNCC) requires the integration of highly complex, multisystem care in the pediatric intensive care unit (PICU) with cutting-edge science. However, for PNCC patients and their families, the acute experience of and recovery from a devastating neurologic injury is inherently a human experience that also requires a coordinated, compassionate and dedicated approach from their health care team. The goal of the Pediatric Neurocritical Care KISC is to reinforce the relationships between management in the acute care environment, long-term outcomes, and the scientific inquiry that supports both of these endeavors. In this KISC, students will complete 3-4 modules (each 1-1.5 weeks in duration, organized around a core PNCC condition). Each module consists of reading/independent study and journal club, exposure to patient care and family narratives, exposure to the multi-professional health care providers within each condition/specialty, and recurring debrief and thematic exploration sessions with the KISC co-directors. For each module, patients are identified (as possible), and students will follow the PNCC patients through multiple clinical environments (PICU, inpatient ward, neurorehabilitation, and outpatient NCFP clinic), evaluating how the healthcare systems change during a patient's care. Students will work with both physicians and non-physician team members, participate in multidisciplinary meetings, and have multiple shadowing opportunities. The key applied activity for the students will center on use of the module curriculum and clinical exposure to develop semi-structured interviews for (at least one) of the PNCC patients and/or families to elucidate a richer understanding of the medical experience. In the journal clubs, students will be led by Wash U investigators who are advancing PNCC basic science in traumatic brain injury (TBI), cardiac arrest, epileptogenesis, stroke/metabolic stress, neuromonitoring, extracorporeal membrane oxygenation (ECMO), neuroplasticity, and post-ICU syndrome. Group debriefs will allow students to compare experiences and reflect on how social determinants of health have impacted care or outcomes. In the final project, students will combine science, health systems, and social factors into a narrative of the patient's illness from onset to outcome.