Abstract:
OBJECTIVES:Literature demonstrates that pediatric residents are not graduating with procedural confidence and competency. This was confirmed with our own institution's Accreditation Council for Graduate Medical Education and internal surveys. Our primary objective was to improve procedural confidence among pediatric residents with the introduction of a mandatory longitudinal pediatric procedural curriculum, including simulation in combination with online modules. METHODS:We performed a quality improvement intervention to increase resident comfort level performing Accreditation Council for Graduate Medical Education-required procedures. This study involved pediatric residents, postgraduation year (PGY) 1-3, at an academic, tertiary care hospital. Between April 2015 and June 2017, the combination of online self-directed learning modules and hands-on simulation curriculum was implemented for pediatric residents. Surveys were administered at 1-year intervals to assess self-reported comfort level on 12 procedures using a Likert scale (1 for "strongly disagree" to 5 for "strongly agree, maximum score of 60 for all procedures). RESULTS:Forty (63%) of 63 participant presurveys and 45 (71%) of 63 postsurveys were available for analysis. The mean comfort level for all procedures demonstrated a statistically significant increase from 32.4 to 37.1, or 12.7% (P = 0.005). By PGY level, the score increased from 24.4 to 30.9 (21%) for PGY1, 34.4 to 37.5 (8.3%) for PGY2, and 38.6 to 42.8 (9.8%) for PGY3 (P < 0.005). Overall, pediatric residents rated the simulation experience very favorably. CONCLUSIONS:A mandatory longitudinal procedure curriculum improved procedural comfort level among pediatric residents. Iterative curriculum designs found the most productive combination to be deliberate practice within mastery learning simulation sessions with required precourse online modules.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Price A,Greene HM,Stem CT,Titus MOdoi
10.1097/PEC.0000000000002324subject
Has Abstractpub_date
2020-12-21 00:00:00eissn
0749-5161issn
1535-1815pii
00006565-900000000-97711journal_volume
Publish Ahead of Printpub_type
杂志文章abstract::Honeycomb gallbladder is a rare congenital malformation of the gallbladder. In some cases, it may be asymptomatic, whereas in others, it may lead to symptoms consistent with biliary colic even in the absence of cholelithiasis. We present the clinical and imaging findings of a case of a 10-year-old boy who was admitted...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000030
更新日期:2013-12-01 00:00:00
abstract::Enterobius vermicularis may cause infections of the gastrointestinal tract and occurs approximately in 4% to 28% of children worldwide. It is most common in children aged 5 to 14 years.The most commonly reported symptoms are pruritus in the perianal region, abdominal pain, urinary tract infection, insomnia, irritabili...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000480
更新日期:2016-04-01 00:00:00
abstract::Pediatric skin diseases are a common presenting complaint to emergency medicine physicians but often pose a significant diagnostic challenge. Skin eruptions that are unusually severe for the diagnosis in question, lasting beyond the typical time of resolution, or not responding to conventional therapy should raise con...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001218
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVES:Helicopter emergency medical services (HEMS) are used for 16% of pediatric trauma. National HEMS guidelines advised that triage criteria be standardized for pediatric patients. A national report found pediatric HEMS associated with decreased mortality compared with ground emergency medical services (GEMS) bu...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002263
更新日期:2020-10-22 00:00:00
abstract::A 4-month-old infant with trisomy 21 is brought to the emergency department for breathing difficulty. Subsequently, he is diagnosed with a Morgagni diaphragmatic hernia. Tachypnea in an infant with trisomy 21 may be the result of diagnosis such as congenital heart disease, infectious processes, structural anomalies, o...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000202457.64978.3d
更新日期:2006-03-01 00:00:00
abstract::Retropharyngeal abscess is a rather rare, deep-neck infection of children and may seriously compromise the airway and mimic other diseases. A retrospective review of 17 cases of retropharyngeal abscess presenting to The Children's Hospital, Denver, from 1976 to 1986 was performed. Nine children (56%) had stridor or ai...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-198803000-00003
更新日期:1988-03-01 00:00:00
abstract::Vomiting in young infants is a common presentation to the pediatric emergency department with a broad differential diagnosis. We present 2 cases seen in our emergency department of infant females with symptomatic complex ovarian cysts who presented with vomiting. The first case study describes a patient with a prenata...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002209
更新日期:2020-08-10 00:00:00
abstract:OBJECTIVE:Emergency department (ED) boarding of admitted patients negatively impacts ED length of stay (LOS). Behavioral health (BH) patients are often challenging to safely discharge. We examined the association between daily BH census and non-BH LOS and left without being seen (LWBS) rates. METHODS:Retrospective ana...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001565
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVES:National guidelines for routine pediatric acute asthma care recommend providing corticosteroids, and discourage routinely obtaining chest radiographs (CXRs) and using antibiotics. We examined rates of adherence to all 3 of these aspects during emergency department (ED) visits and compared performance between...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001706
更新日期:2019-01-07 00:00:00
abstract::The purpose of this study is to report 18 cases of membranous laryngotracheobronchitis (MLTB) and to review 143 published cases in order to accurately characterize the epidemiology, presentation, clinical course, treatment, and outcome of patients with this disorder. The male:female ratio was 2:1; mean age was four ye...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199112000-00004
更新日期:1991-12-01 00:00:00
abstract::We describe the case of an 18-month-old child with recurrent apneic episodes, often requiring resuscitation, who was admitted to an academic pediatric medical center after previous evaluations had been unrevealing. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318180ff44
更新日期:2008-08-01 00:00:00
abstract:INTRODUCTION:Although retropharyngeal infection (RPI) may present with voice change, drooling, fever, and a toxic appearance, diagnosis based on symptoms alone is unreliable. As incidence is increasing in children and drug-resistant bacterial strains such as methicillin-resistant Staphylococcus aureus are becoming more...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001318
更新日期:2020-05-01 00:00:00
abstract::A 17-year-old adolescent girl with no past medical history presented to the emergency department with a chief complaint of lower back pain after sustaining a minor fall several hours earlier. Physical examination revealed mild to moderate back tenderness, and the result of review of systems was negative. Laboratory ev...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181bec953
更新日期:2009-11-01 00:00:00
abstract:OBJECTIVE:To evaluate computed tomography (CT) findings in pediatric patients with viral gastroenteritis who presented with clinical features of acute abdomen. PATIENTS AND METHODS:During 2 seasons of viral gastroenteritis from 2005 to 2007, 302 children with acute gastrointestinal symptoms were admitted to our center...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181850cc8
更新日期:2008-09-01 00:00:00
abstract::A case report of an 11-month-old infant with cocaine intoxication and intussusception is presented. We present this case because there are no prior reports in the literature of cocaine intoxication associated with intussusception. The diagnosis was not initially considered in this patient. We feel the association is b...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199412000-00010
更新日期:1994-12-01 00:00:00
abstract::Forty-three nonhemophiliac, confirmed HIV-positive children followed by the Children's Hospital AIDS Program made 184 visits to the children's Emergency Department (ED) during 1988 and 1989. The mean age was 30 +/- 28 months with a median of 25 months, a mode of 10 months, and a range from two days to 19 years. CD4 co...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199310000-00002
更新日期:1993-10-01 00:00:00
abstract:OBJECTIVES:The majority of US children do not have access to an emergency department (ED) with a pediatric mental health care policy in place. Our objective was to understand factors associated with whether US EDs have a pediatric mental health care policy. METHODS:We analyzed data from the National Pediatric Readines...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001920
更新日期:2019-11-13 00:00:00
abstract::Penetrating middle ear injury may cause hearing loss, vertigo, or facial nerve injury, although facial nerve paralysis followed by head trauma is a rare condition. In this study, we report a case of a 3-year-old patient with delayed facial palsy on the left side that developed 4 days after an accidental tympanic membr...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001875
更新日期:2019-07-25 00:00:00
abstract:OBJECTIVES:Limited literature has investigated caregiver sharing of prescription medications with children. Our primary aim was to determine the frequency of and factors associated with prescription medication sharing within families. Our secondary aim was to determine the source and type of medications shared. METHOD...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001804
更新日期:2019-04-30 00:00:00
abstract::We report a case of a six-year-old male who sustained a ventricular septal defect following blunt trauma to the chest. Traumatically acquired VSD is rare in children. The diagnosis is made by characteristic history and physical examination and confirmed by echocardiogram or cardiac catheterization. Treatment is medica...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-198612000-00009
更新日期:1986-12-01 00:00:00
abstract:OBJECTIVES:Young children are highly vulnerable to elemental mercury toxicity, and elementary mercury exposure in young children in China unfortunately occurs regularly because of the wide use of fluorescent lamps, glass thermometers, and other mercury-contained items. This study aimed to summarize such recent cases in...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000305
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVE:We present a survey of sex differences and socio-demographic and clinical variables in children and adolescents receiving a psychiatric consultation service in an emergency department (ED). METHODS:This observational, retrospective, and cross-sectional study included all records of patients (age, <18 years) ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000505
更新日期:2015-06-27 00:00:00
abstract::Pediatric emergency physicians must have a high clinical suspicion for atlantoaxial rotatory subluxation (AARS), particularly when a child presents with neck pain and an abnormal head posture without the ability to return to a neutral position. As shown in the neurosurgical literature, timely diagnosis and swift initi...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0000000000000817
更新日期:2016-10-01 00:00:00
abstract::Fructose-1,6-diphosphatase (FDPase) enzyme deficiency is a rare inherited metabolic disease. Affected patients usually present with metabolic crisis including hypoglycemia, acidosis, ketonuria, and hyperuricemia. A previously healthy 8-month-old male infant presented with fever, vomiting, and hypoactivity. He had tach...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31823b412d
更新日期:2011-12-01 00:00:00
abstract::The recent popularity of elastic bands on the wrist may put children at risk for acute compartment syndrome. Acute compartment syndrome is a limb-threatening condition characterized by elevated interstitial pressure in a confined fascial compartment. If left untreated, it may result in tissue necrosis, irreversible ne...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318217b5a7
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVES:To examine attitudes toward the use of oral rehydration therapy (ORT) by pediatric emergency medicine physicians before and after being given recent data that might affect their practice and to see if there is a difference in responses based upon year of graduation from medical school. METHODS:A national su...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318149f66f
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:Child abuse is a leading pediatric public health problem. Pediatric emergency physicians are on the front line to identify and respond to child abuse. The physician's response to suspected child abuse cases is influenced by educational content and experience. OBJECTIVE:To determine pediatric emergency medic...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199912000-00002
更新日期:1999-12-01 00:00:00
abstract:OBJECTIVE:We examined financial barriers to care experienced by US school-aged children with disabilities. METHODS:Data from the 2005 National Health Interview Survey were analyzed. Children aged 5 to 17 years were classified into 4 health condition groups: children with activity limitations, disabling conditions, chr...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318180fda3
更新日期:2008-08-01 00:00:00
abstract::A case history of a young girl who sustained a small posterior laceration of her cervical trachea after blunt trauma is presented. She was brought to the emergency department (ED) by her parents roughly two hours after the incident with only minor symptoms. While in the ED, she developed significant airway compromise ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199110000-00008
更新日期:1991-10-01 00:00:00
abstract::Medical directors of pediatric emergency departments were surveyed by mail to determine the present role of their pediatric hospitals in general, and emergency departments in particular, in the evaluation and management of pediatric sexual assault and abuse. Seventy-four percent of the responses were from communities ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-198809000-00003
更新日期:1988-09-01 00:00:00