Gaps in pediatric emergency medicine education of emergency medicine residents: A needs assessment of recent graduates.

Autor: Schoppel K; Indiana University School of Medicine, Riley Hospital for Children Indianapolis Indiana USA., Spector J; Boston University Chobanian & Avedisian School of Medicine Boston Medical Center Boston Massachusetts USA., Okafor I; Boston University Chobanian & Avedisian School of Medicine Boston Medical Center Boston Massachusetts USA., Church R; University of Massachusetts Medical School Worcester Massachusetts USA., Deblois K; Kent Hospital Warwick Rhode Island USA., Della-Giustina D; Yale School of Medicine New Haven Connecticut USA., Kellogg A; Umass Chan Baystate Worcester Massachusetts USA., MacVane C; Maine Medical Center Tufts University School of Medicine Portland Maine USA., Pirotte M; Vanderbilt University Medical Center Nashville Tennessee USA., Snow D; Loyola University Medical Center Maywood Illinois USA., Hays G; Indiana University School of Medicine, Riley Hospital for Children Indianapolis Indiana USA., Mariorenzi A; Alpert Medical School of Brown University Providence Rhode Island USA., Connelly H; Boston University Chobanian & Avedisian School of Medicine Boston Medical Center Boston Massachusetts USA., Sheng A; Alpert Medical School of Brown University Providence Rhode Island USA.
Jazyk: angličtina
Zdroj: AEM education and training [AEM Educ Train] 2023 Nov 29; Vol. 7 (6), pp. e10918. Date of Electronic Publication: 2023 Nov 29 (Print Publication: 2023).
DOI: 10.1002/aet2.10918
Abstrakt: Background: More than 90% of pediatric patients presenting to emergency departments (EDs) in the United States are evaluated and treated in community-based EDs. Recent evidence suggests that mortality outcomes may be worse for critically ill pediatric patients treated at community EDs. The disparate mortality outcomes may be due to inconsistency in pediatric-specific education provided to emergency medicine (EM) trainees during residency training. There are few studies surveying recently graduated EM physicians assessing perceived gaps in the pediatric emergency medicine (PEM) education they received during residency.
Methods: This was a prospective, survey-based, descriptive cohort study of EM residency graduates from 10 institutions across the United States who were <5 years out from residency training. Deidentified surveys were distributed via email.
Results: A total of 222 responses were obtained from 570 eligible participants (39.1%). Non-ED pediatric rotations during residency training included pediatric intensive care (60%), pediatric anesthesia (32.4%), neonatal intensive care unit (26.1%), and pediatric wards (17.1%). A large percentage (42.8%) of respondents felt uncomfortable managing neonates and performing tube thoracostomy on pediatric patients (56.3%). The EM graduate's satisfaction with pediatric simulation-based training during residency was positively associated with comfort caring for neonates and infants ( p  < 0.0070 and p  < 0.0002) and performing endotracheal intubation ( p  < 0.0027), lumbar puncture ( p  < 0.0004), and Pediatric Advanced Life Support resuscitation ( p  < 0.0001).
Conclusions/discussion: This survey-based cohort study found considerable variation in pediatric-specific experiences during EM residency training and in perceived comfort managing pediatric patients. In general, participants were more comfortable managing older children. This study suggests that the greatest perceived knowledge gaps in PEM were neonatal medicine/resuscitation and pediatric cardiac arrest. Future research will continue to address larger cohorts, representative of the PEM education provided to EM physicians in the United States to promote future educational initiatives.
Competing Interests: The authors declare no conflicts of interest.
(© 2023 Society for Academic Emergency Medicine.)
Databáze: MEDLINE
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