1
|
De Cloedt L, Jeffers J, Alix-Séguin L, Sauthier M, Tremblay-Roy JS, Pettersen G. Pediatric Interfacility Transport Curriculum: Its Impact on the Pediatric Intensive Care and Emergency Medicine Fellows' Performance and Confidence. Air Med J 2022; 41:442-446. [PMID: 36153140 DOI: 10.1016/j.amj.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/24/2022] [Accepted: 06/27/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Pediatric interfacility transports are frequent. Despite the absence of a formal pediatric transport curriculum in eastern Canada, directly managing patients during transport and medical direction of the referring center and transport team are part of the pediatric critical care medicine (PCCM) and pediatric emergency medicine (PEM) program requirements. The authors developed a pediatric interfacility transport curriculum and measured its impact on fellows' confidence and performance. METHODS This was a pilot interventional prospective study in Montreal, Canada. Postcurriculum surveys were used to measure confidence, and high-fidelity simulations were used to measure performance. A target threshold for confidence was defined before implementation, and pre- and post values were compared. The simulation scenario and assessment checklist were locally developed. RESULTS The participants were 11 PCCM and 3 PEM fellows. The content of the curriculum and educational methods were selected based on the literature and a needs assessment survey. All participants rated themselves as confident at the end of the curriculum. Eighty-three percent of the participants were deemed proficient with a perfect interrater agreement. CONCLUSION The pediatric transport curriculum had a positive impact on PEM and PCCM fellows' confidence and performance in transport. Further studies should look at the impact of such a curriculum on participants' real-life performance and patient care.
Collapse
Affiliation(s)
| | - Justin Jeffers
- Division of Pediatric Emergency Medicine, Department of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Laurence Alix-Séguin
- Department of Pediatric Emergency Medicine, Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Quebec, Canada
| | - Michaël Sauthier
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Quebec, Canada
| | - Jean-Sébastien Tremblay-Roy
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Centre Hospitalier Universitaire de Sherbrooke, University of Sherbrooke, Sherbrooke, Canada
| | - Géraldine Pettersen
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Quebec, Canada.
| |
Collapse
|
2
|
Good RJ, Zurca AD, Turner DA, Bjorklund AR, Boyer DL, Krennerich EC, Petrillo T, Rozenfeld RA, Sasser WC, Schuette J, Tcharmtchi MH, Watson CM, Czaja AS. Transport Medical Control Education for Pediatric Critical Care Fellows: A National Needs Assessment Study. Pediatr Crit Care Med 2022; 23:e55-e59. [PMID: 34261945 DOI: 10.1097/pcc.0000000000002803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Characterize transport medical control education in Pediatric Critical Care Medicine fellowship. DESIGN Cross-sectional survey study. SETTING Pediatric Critical Care Medicine fellowship programs in the United States. SUBJECTS Pediatric Critical Care Medicine fellowship program directors. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS We achieved a 74% (53/72) response rate. A majority of programs (85%) require fellows to serve as transport medical control, usually while carrying out other clinical responsibilities and sometimes without supervision. Fellows at most programs (80%) also accompany the transport team on patient retrievals. Most respondents (72%) reported formalized transport medical control teaching, primarily in a didactic format (76%). Few programs (25%) use a standardized assessment tool. Transport medical control was identified as requiring all six Accreditation Council for Graduate Medical Education competencies, with emphasis on professionalism and interpersonal and communication skills. CONCLUSIONS Transport medical control responsibilities are common for Pediatric Critical Care Medicine fellows, but training is inconsistent, assessment is not standardized, and supervision may be lacking. Fellow performance in transport medical control may help inform assessment in multiple domains of competencies. Further study is needed to identify effective methods for transport medical control education.
Collapse
Affiliation(s)
- Ryan J Good
- Section of Critical Care Medicine, Department of Pediatrics, University of Colorado at Denver, Anschutz Medical Campus, Denver, CO
| | - Adrian D Zurca
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Penn State Children's Hospital, Hershey, PA
| | - David A Turner
- Competency-Based Medical Education, American Board of Pediatrics, Chapel Hill, NC
- Division of Pediatric Critical Care, Department of Pediatrics, Duke University Hospital and Health System, Durham, NC
| | - Ashley R Bjorklund
- Division of Pediatric Critical Care, University of Minnesota, Minneapolis, MN
| | - Donald L Boyer
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Emily C Krennerich
- Section of Pediatric Critical Care, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX
| | - Toni Petrillo
- Division of Critical Care Medicine, Department of Pediatrics, Emory School of Medicine, Atlanta, GA
| | - Ranna A Rozenfeld
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Hasbro Children's Hospital, Brown University, Providence, RI
| | - William C Sasser
- Division of Pediatric Critical Care Medicine, University of Alabama - Birmingham, Birmingham, AL
| | - Jennifer Schuette
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Children's Center and Johns Hopkins School of Medicine, Baltimore, MD
| | - M Hossein Tcharmtchi
- Section of Pediatric Critical Care, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX
| | - Christopher M Watson
- Department of Pediatrics, Medical College of Georgia at Augusta University, Augusta, GA
| | - Angela S Czaja
- Section of Critical Care Medicine, Department of Pediatrics, University of Colorado at Denver, Anschutz Medical Campus, Denver, CO
| |
Collapse
|
3
|
Whitmer G, Smoker S, Luk JH. Evaluation of Physicians' Attitudes Regarding Transport Modalities. Air Med J 2021; 40:415-418. [PMID: 34794781 DOI: 10.1016/j.amj.2021.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 07/30/2021] [Accepted: 08/06/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Hospital mergers have made interhospital transfers necessary in the consolidation of medical services. Physicians must make decisions on the level of interfacility transport modalities (ITMs). We sought to assess physician knowledge of and comfort with ITMs. METHODS A survey was e-mailed to 2,510 physicians in a health care system. Participation was voluntary and anonymous. The mean and median Likert values were calculated overall. Similar calculations were performed for emergency medicine physicians (EMPs) and critical care physicians (CCPs). These calculations were compared with those for noncritical care physicians (NCCPs) using the t-test and Mann-Whitney test. RESULTS Of the 181 physicians who responded, 169 physicians identified a specialty. Sixty-nine were EMPs/CCPs, whereas 100 were NCCPs. The mean and median Likert values were statistically significantly higher for EMPs/CCPs compared with NCCPs (P < .0001) in the areas of knowledge of ITMs, comfort in choosing ITMs, and knowledge in choosing ground versus air critical care transport (CCT). The most important factor for using ground or air CCT was patient stability. Sixty percent believed air CCT to be faster than ground. CONCLUSION EMPs/CCPs seem to be more comfortable with ITMs than NCCPs. Further research should evaluate whether educational interventions lead to a more appropriate use of ITMs.
Collapse
Affiliation(s)
| | | | - Jeffrey H Luk
- Case Western Reserve University, Cleveland, OH; Department of Emergency Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH.
| |
Collapse
|