Pediatric Emergency Medicine Fellow Physician John R. Oishei Children's Hospital Cheektowaga, New York, United States
Background: One of the American Board of Pediatrics competencies is patient care and procedural skills. They require pediatric residents develop and carry out patient care management plans, including performing procedures. Training in these procedures has been a vital part of pediatric residency training. However, several previous studies have shown residents find these procedures difficult to perform, and are uncomfortable performing them after graduation. Objective: The goal of this study was to determine if participation in a procedure module will improve resident confidence in performing procedures. Design/Methods: A 2 week procedure module was created for pediatric residents. The module included a didactic day, with lectures and simulation, as well as scheduled days in various areas of the hospital where they would have frequent exposure to procedures. All pediatric residents were surveyed on confidence of completing procedures prior to the implementation of the module and 1 year after implementation. Procedure logs of residents completing the procedure rotation were also reviewed. Results: Of the 55 residents in our program 19 successfully completed both surveys. Of those, 8 participated in the procedure module and 11 did not. 230 procedures were performed by residents completing the procedure elective, averaging 28.8 procedures per participant. Comfort change for procedures from intervention to control groups as follow: peripheral intravenous insertion 0.75 vs 0.25 (KW=0.861, p=0.353), nasogastric tube insertion 0.63 vs 0.36 (KW=0.916, p=0.339), lumbar puncture 0.50 vs 0.63 (KW=0.059, p=0.808), suturing 0.39 vs 0.25 (unable to calculate KW/p), splinting 0.38 vs 0.08 (KW=0.561, p=0.454), incision and drainage 0 vs 0.64 (KW=1.205, p=0.272), intubation -0.25 vs 0.04 (KW=1.401, p=0.237), umbilical venous catheter insertion 0.38 vs 0.08 (KW=0.599, p=0.439), umbilical arterial catheter insertion 0.13 vs 0.25 (KW=0.196, p=0.658), intraosseous insertion 0 vs -0.25 (KW=0.679, p=0.41), and foley insertion 0.25 vs 0.25 (KW=0.016, p=0.899).
Conclusion(s): Pediatric residents who completed a procedure module were able to successfully preform a substantial amount of procedures during the module. There was an overall trend of increased improvement in confidence for those who participated in the module however, no statistically significant difference. Both groups showed improved confidence in most procedures over the course of the year.
.jpg "Susana Ruano, MD (she/her/hers) photo")