A randomized controlled trial of a point-of-care computerized intervention to improve family knowledge of environmental triggers for children with asthma

• Published in: Pediatrics (Evanston) 2019-08, Vol.144 (2_MeetingAbstract), p.419-419
• Main Authors: Edwards, Julianne E., Garro, Aris C., Congdon, Elizabeth A., Frackiewicz, Laura M., Hipolito, Evelyn R.
• Format: Article
• Language: English
• Subjects: Agreements; Asthma; Curricula; Emergency medical care; Emergency medical services; Image quality; Internet; Pediatrics; Quality control; Ranking; Scholarships & fellowships; Ultrasonic imaging; Ultrasound
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.144.2MA5.419

Background and Objective: Most pediatric emergency medicine (PEM) fellowships incorporate point-of-care ultrasound (POCUS) training into their curricula. The lack of standardized assessment tools results in variability in the assessment of fellows' POCUS competency. The common forms of assessment include direct observation, image review, quality assessment, and online or locally developed written examinations. We aimed to develop an evidence-based and consensus-derived template that will serve as a standardized structure for a pediatric POCUS competency assessment tool. Methods: Three authors searched PubMed for relevant full-text articles published June 2005 through June 2015, using the following search terms: POCUS, emergency ultrasound, bedside ultrasound and pediatric emergency department. The identified literature was used to frame the content for the initial three templates for a nominal group process. Each contained a minimum of 19 common pediatric POCUS applications, with variable weighted distributions for testing (Table 1). In the first round of the nominal group process, reviewers provided feedback on the template using a standardized worksheet to modify and develop subsequent templates. In the second round, reviewers met via a web-based group meeting. Each template was ranked for level of importance and anticipated necessity in a PEM POCUS assessment tool. Templates were ranked using a 9-point scale with predefined regions of agreement: 1-3 (template should not be used); 4-6 (equivocal); and 7-9 (template should be used). At that time, they completed an updated ranking, discussion, modification, and final ranking of the templates. Our goal of strict agreement was obtained if all rankings fell within the range of one of the predefined regions of agreement. Results: A total of fifteen pediatric POCUS content experts from the United States and Canada reviewed the templates. After the first round, there was strict agreement to eliminate template 1. The second round resulted in strict agreement to eliminate template 2. Further discussion led to a modification of template 3 into two versions, 3A and 3B. Ultimately, the group reached strict agreement on template 3A. This template includes 17 POCUS applications (Table 2). Conclusions: Through a nominal group process, we developed an evidence-based and consensus-driven template with weighted distributions of each topic. This template will serve as a standardized structure for the development of a catego