BMC Research Notes | |
Program directors’ perceptions of importance of pediatric procedural skills and resident preparedness | |
Harish J. Amin1  Adam Dubrowski2  Zia Bismilla3  | |
[1] University of Calgary, Calgary, Canada;Memorial University, St. John’s, Canada;University of Toronto, 555 University Avenue, Toronto M5G 1X8, ON, Canada | |
关键词: Simulation; Assessment; Curriculum; Competency; Pediatrics; Residency; Procedures; Medical education; | |
Others : 1229609 DOI : 10.1186/s13104-015-1499-8 |
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received in 2015-05-26, accepted in 2015-09-21, 发布年份 2015 |
【 摘 要 】
Background
The Royal College of Physicians and Surgeons of Canada (RCPSC) objectives for training in pediatrics include 26 procedural skills, 11 of which are included in the final in-training evaluation report (FITER). The importance of each procedure for practice and the preparedness of pediatric residency graduates to perform these procedures are not known.
Methods
A questionnaire was distributed to all pediatric residency program directors and members of the RCPSC Specialty Committee in Pediatrics (N = 21) in October 2010, requesting them to rate the perceived importance and preparedness of graduating pediatric residents in all procedural skills on a 5 point Likert scale, as well as the presence of a curriculum and documentation for each procedure. Mean importance and preparedness were calculated for each procedure.
Results
Response rate was 16/21 (76 %). Perceived preparedness was significantly lower than importance for the majority of procedures (p < 0.05). Ten procedures had a high mean importance rating (>3) but a low mean preparedness rating (<3). Presence of a curriculum and documentation for procedures varied across centers, and their presence was correlated with both perceived importance and preparedness (p < 0.0001).
Conclusions
Many procedures in which pediatric residents are required to be competent by the RCPSC are felt to be important. Residents are not felt to be adequately prepared in several of the required procedures by the time of graduation. Procedures with high ratings of importance but low preparedness ratings should be targeted for curricular interventions.
【 授权许可】
2015 Bismilla et al.
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【 参考文献 】
- [1]Tallentire VR, Smith SE, Wylde K, Cameron HS (2011) Are medical graduates ready to face the challenges of foundation training? Postgrad Med J. doi:10.1136/pgmj.2010.115659.
- [2]Gaies MG, Landrigan CP, Hafler JP, Sandora TJ: Assessing procedural skills training in pediatric residency programs. Pediatrics 2007, 120:715-722.
- [3]White JR, Shugerman R, Brownlee C, Quan L: Performance of advanced resuscitation skills by pediatric housestaff. Arch Pediatr Adolesc Med 1998, 152:1232-1235.
- [4]Nadel FM, Lavelle JM, Fein JA, Giardino AP, Decker JM, Durbin DR: Assessing pediatric senior residents’ training in resuscitation: fund of knowledge, technical skills, and perception of confidence. Pediatr Emerg Care 2000, 16:73-76.
- [5]Buss PW, McCabe M, Evans RJ, Davies A, Jenkins H: A survey of basic resuscitation knowledge among resident paediatricians. Arch Dis Child 1993, 68:75-78.
- [6]O’Donnell CP, Kamlin CO, Davis PG, Morley CJ: Endotracheal intubation attempts during neonatal resuscitation: success rates, duration, and adverse effects. Pediatrics 2006, 117:e16-e21.
- [7]Leone TA, Rich W, Finer NN: Neonatal intubation: success of pediatric trainees. J Pediatr 2005, 146:638-641.
- [8]Falck AJ, Escobedo MB, Baillargeon JG, Villard LG, Gunkel JH: Proficiency of pediatric residents in performing neonatal endotracheal intubation. Pediatrics 2003, 112:1242-1247.
- [9]Amin HJ, Singhal N, Cole G: Validating objectives and training in Canadian paediatrics residency training programmes. Med Teach 2011, 33:e131-e144.
- [10]Hilliard R, Bannister SL, Amin H, Baird B: Paediatric medical education: challenges and new developments. Paediatr Child Health 2009, 14:303-309.
- [11]Lieberman L, Hilliard RI: How well do paediatric residency programmes prepare residents for clinical practice and their future careers? Med Educ 2006, 40:539-546.
- [12]Bannister SL, Hilliard RI, Regehr G, Lingard L: Technical skills in paediatrics: a qualitative study of acquisition, attitudes and assumptions in the neonatal intensive care unit. Med Educ 2003, 37:1082-1090.
- [13]The Royal College of Physicians and Surgeons of Canada giving you the tools to make competency by design a reality. http://www.royalcollege.ca/portal/page/portal/rc/resources/cbme. Accessed 2 Nov 2015.
- [14]The draft CanMEDS 2015 physician competency framework—series IV. The Royal College of Physicians and Surgeons of Canada, Ottawa; 2015.
- [15]Holmboe ES, Sherbino J, Long DM, Swing SR, Frank JR: The role of assessment in competency-based medical education. Med Teach 2010, 32:676-682.
- [16]Royal College of Physicians and Surgeons of Canada. Objectives of training in pediatrics. 2008. http://www.royalcollege.ca/cs/groups/public/documents/document/y2vk/mdaw/~edisp/tztest3rcpsced000931.pdf. Accessed 1 Oct 2015.
- [17]Oliver TK Jr, Butzin DW, Guerin RO, Brownlee RC: Technical skills required in general pediatric practice. Pediatrics 1991, 88:670-673.
- [18]Wigton RS, Blank LL, Nicolas JA, Tape TG: Procedural skills training in internal medicine residencies. A survey of program directors. Ann Intern Med 1989, 111:932-938.
- [19]Ericsson KA: Deliberate practice and acquisition of expert performance: a general overview. Acad Emerg Med 2008, 15:988-994.
- [20]Card SE, Snell L, O’Brien B: Are Canadian General Internal Medicine training program graduates well prepared for their future careers? BMC Med Educ 2006, 6:56. BioMed Central Full Text
- [21]Tenore JL, Sharp LK, Lipsky MS: A national survey of procedural skill requirements in family practice residency programs. Fam Med 2001, 33:28-38.
- [22]Sharp LK, Wang R, Lipsky MS: Perception of competency to perform procedures and future practice intent: a national survey of family practice residents. Acad Med 2003, 78:926-932.
- [23]Bismilla Z, Breakey VR, Swales J, Kulik DM, Pai N, Singh N, Parshuram CS: Prospective evaluation of residents on call: before and after duty-hour reduction. Pediatrics 2011, 127:1080-1087.
- [24]Van der Goes T, Grzybowski SC, Thommasen H: Procedural skills training. Canadian family practice residency programs. Can Fam Physician 1999, 45:78-85.
- [25]Gaies MG, Morris SA, Hafler JP, Graham DA, Capraro AJ, Zhou J, Landrigan CP, Sandora TJ: Reforming procedural skills training for pediatric residents: a randomized, interventional trial. Pediatrics 2009, 124:610-619.
- [26]Eppich WJ, Adler MD, McGaghie WC: Emergency and critical care pediatrics: use of medical simulation for training in acute pediatric emergencies. Curr Opin Pediatr 2006, 18:266-271.
- [27]Trainor JL, Krug SE: The training of pediatric residents in the care of acutely ill and injured children. Arch Pediatr Adolesc Med 2000, 154:1154-1159.
- [28]Nadel FM, Lavelle JM, Fein JA, Giardino AP, Decker JM, Durbin DR: Teaching resuscitation to pediatric residents: the effects of an intervention. Arch Pediatr Adolesc Med 2000, 154:1049-1054.
- [29]McLaughlin SA, Doezema D, Sklar DP: Human simulation in emergency medicine training: a model curriculum. Acad Emerg Med 2002, 9:1310-1318.
- [30]Issenberg SB, McGaghie WC, Petrusa ER, Lee Gordon D, Scalese RJ: Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Med Teach 2005, 27:10-28.
- [31]McGaghie WC, Issenberg SB, Cohen ER, Barsuk JH, Wayne DB: Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Acad Med 2011, 86(6):706-711.