23. INCREASED EXPOSURE TO PROCEDURAL TRAINING IN RESIDENCY

• Published in: Academic pediatrics 2019-08, Vol.19 (6), p.e12-e12
• Main Authors: Saladik, Monica, MD, Gilmore, William, MD, Fisher, Colin, MD, Waagmeester, Laura, MD, Bailey, Jessica, MD, Aylor, Megan, MD
• Format: Article
• Language: English
• Subjects: Neonatal and Perinatal Medicine; Pediatrics
• ISSN: 1876-2859; 1876-2867
• DOI: 10.1016/j.acap.2019.05.037

BackgroundOur program's most recent ACGME Resident Survey revealed that residents felt inadequately prepared to perform many required procedures without supervision. Moreover, current residents noted a poor understanding about which procedures are considered “essential” by the ACGME and independently voiced a desire for more dedicated training in emergent stabilization of critically ill children. ObjectiveImprove procedural competency in pediatric residents through education, dedicated procedural time, and simulation. MethodsOur program pursued the following methods: 1) Design and distribute a procedure passport for resident reference. This credit card sized tool delineates the 13 “essential” ACGME procedures and includes a target number of procedures to complete on certain rotations. 2) Develop a half day experience where residents work with a nurse completing procedures such as intravenous catheter placement, venipuncture, and bladder catheterization in the ED. 3) Organize intensive small-group sessions to emphasize bag valve mask ventilation and pediatric intubation. Each resident completes these half day simulated code experiences annually in addition to our monthly mock code curriculum. ResultsWe obtained survey responses from residents about the utilization of the passport, and 47% felt it helped them better understand ACGME requirements. Additionally, 24% felt the passport helped them take initiative to complete procedures independently. Of the residents paired with nurses, 92% felt it was valuable. In addition to the previously listed procedures, residents also completed arterial draws, intraosseous lines, incisions and drainage, laceration repairs, and nasogastric tube placements. ConclusionsA clear and tangible delineation of ACGME requirements helps educate and support residents independently completing procedures. Furthermore, increasing clinical time in areas with high procedural volume seems to be both well regarded and clinically beneficial. The expanded use of simulation has promise as an educational tool for procedural practice, and we are currently evaluating its utility as well as launching a procedural elective.