Something New
During my pediatrics rotation, I was fortunate to have a significant amount of one-on-one mentorship from a very engaging and energetic PA who helped understand pediatric medication dosing. One of the most useful skills I learned was how to calculate weight-based dosages for common pediatric medications such as acetaminophen, ibuprofen, and amoxicillin. At first, I found myself double-checking the math frequently, but with repeated practice, I became more comfortable calculating doses and understanding exactly why careful documentation of the child’s weight was emphasized so much during the rotation. We also spoke extensively about different treatment strategies including supportive care for viral illnesses, management of suspected bronchiolitis, treatment of allergic or irritant eye symptoms, and counseling families on when symptoms require urgent evaluation.
Skills, Challenges, and Action Plan
One interpersonal challenge I encountered during this rotation was communication. The patient population at my site was predominantly Hispanic and Asian. This required patience and reminded me of the importance of meeting patients and families where they are. I learned to slow down my usual fast speech and use much simpler language while relying on appropriate translation support when needed.
An interprofessional skill I frequently used was presenting patients to my preceptor in a concise and coherent manner after obtaining a thorough history. At one of the offices, my preceptor was an older physician who made it clear that he appreciated when students spoke clearly, at a steady pace, and in an organized way. This helped me become more intentional about how I presented patients. I quickly learned how to formulate a concise and appropriate presentation. This is a skill I want to continue improving because clear presentations help to ultimately improve patient care and improve communication.
One situation I found difficult was performing procedures on pediatric patients, especially venipunctures and vaccinations. Children may be fearful, crying, moving, or unable to fully understand why the procedure is necessary. These situations require a balance between patience, time management, and safety, especially when sharps are involved. I improved by learning how to speak calmly to the patient, explain the procedure in age-appropriate terms, involve the parent when helpful, and complete the procedure efficiently while still being gentle. Moving forward, I would like to continue improving my pediatric procedural skills, especially blood draws in patients whose veins are not easily visible due to age, movement, or poor hydration status. My action plan is to ask for more opportunities to perform venipuncture during future rotations and to observe how those are more experienced than myself position pediatric patients safely.
Another challenging area was counseling older pediatric patients and families about diet and lifestyle changes. Some patients had elevated cholesterol, obesity, or dietary habits that required counseling, but these conversations can be difficult because food choices are often influenced by family routines, culture, finances, and patient preferences. I learned that rather than simply telling families what not to eat, it is more effective to ask about their usual meals and then suggest realistic changes that they can implement. In the future, I plan to improve by making sure that I ask about barriers and by encouraging gradual changes,
One of the most difficult patient encounters involved a child with a disclosure concerning for inappropriate sexual contact by another child. Initially, I did not feel fully prepared for how emotionally sensitive and legally important the situation was. However, during the encounter, I realized that the most important approach was to keep the patient at the center of the conversation and make sure both the patient and parent felt heard, respected, and safe. This case taught me the importance of careful documentation, avoiding judgmental language, and understanding the role of mandatory reporting. Going forward, I plan to improve by documenting more specific details in sensitive cases, such as the time CPS was contacted, who was spoken to, and any case or reference number provided.
Another challenging patient population was autistic and non-verbal children. I noticed that these encounters can be stressful not only for the child, but also for the parents, who may already be exhausted from managing daily challenges. I learned that the best approach is to reduce overstimulation, avoid prolonged or loud conversation, move slowly, explain each step before touching the patient, and allow the caregiver to guide the encounter when appropriate. These patients reminded me that a successful exam is not always about completing every part perfectly, but about adapting to the child’s needs while still obtaining the most clinically relevant information.
In terms of areas for improvement, I would like more exposure to pediatric urgent care and emergency presentations, including respiratory distress, dehydration, fever in infants, and acute abdominal pain. I gained valuable experience with an infant with suspected bronchiolitis, but I would like to continue developing my confidence in recognizing when a pediatric patient can be managed outpatient versus when they require ED evaluation. My action plan is to pay closer attention to red flag symptoms, continue reviewing pediatric vital sign norms by age, and ask preceptors for feedback on my assessment and disposition decisions.
Memorable Experiences
One memorable experience involved a mother who came in deeply concerned after hearing that her son had been accused of harming and violating the rights of other children at a family party. As the history was further revealed, it became clear that the reported witness had given two different versions of the story: one where the son was the perpetrator and another where he was the victim. After interviewing both the patient and the mother, it became evident that the witness was unreliable and may have had a hidden agenda. This was a memorable case because it taught me how important it is to stay calm, objective, and thorough when emotions are raging.
The knowledge gained from this case is applicable to all areas of medicine. Whether in pediatrics, emergency medicine, psychiatry, family medicine, or surgery, clinicians often encounter situations where patients and families are upset, confused, or presenting with conflicting information. This case reinforced that my role is not to make assumptions, but to gather information carefully, consider all sides, protect the patient’s safety, and de-escalate the situation when needed. It also showed me that strong communication skills are just as important as medical knowledge.
Overall Reflection and Perspective
During this five-week pediatrics rotation, I learned that even though my main interests in medicine are not specifically centered on pediatrics, my overall willingness to serve patients and the public keeps me focused and motivated. I realized that I can still find meaning in a rotation even when it is not my preferred specialty, especially when I focus on improving my clinical skills, helping families, and becoming a more well-rounded provider.
My perspective on pediatrics changed throughout the rotation. Before starting, I thought of pediatrics mainly as well-child visits, vaccines, and common viral illnesses. However, I quickly learned that pediatrics requires a strong understanding of age-specific anatomy, development, communication, dosing, and disease presentation. Children are indeed small adults in a way, and but even the most routine complaints require careful attention to age, growth, development, parental concern, and safety.
One thing I would want my preceptor and colleagues to notice about my work during this rotation is my attention to the patient’s comfort. A patient even commented on my soft touch, which meant a lot to me because I try to always make a conscious effort to pay attention to facial expressions, body language, and signs of discomfort during exams and procedures. In pediatrics, this is especially important because children may not always verbalize pain or fear clearly.
Overall, this rotation helped me grow in my pediatric assessment skills, communication, documentation, and patient-centered care. I became more comfortable with pediatric medication dosing, focused histories, physical exams, and counseling families. At the same time, I identified areas where I still need improvement, including pediatric procedures, documentation in sensitive cases, and managing acute pediatric presentations. I plan to continue working on these skills by seeking feedback, asking for more hands-on opportunities, and observing how experienced clinicians communicate with children and families.
