Pediatric Orthopaedic Associates, Marietta, Georgia.
Nova Southeastern University, Fort Lauderdale, Florida.
J Surg Educ. 2018 Jul-Aug;75(4):901-906. doi: 10.1016/j.jsurg.2017.10.012. Epub 2017 Nov 7.
To evaluate the distribution of conditions presented at a case conference to assess resident educational exposure to acute pediatric orthopedic conditions.
Retrospective review of emergency department and inpatient consultations presented at a daily pediatric orthopedic case conference over a 3-year period. Consultations were divided into 3-month resident rotation blocks for analysis.
Tertiary children's hospital in the southern United States which host residents from 2 orthopedic surgery residency programs.
The case conference is attended by pediatric orthopedic surgeons, 1 pediatric orthopedic fellow, and 4 PGY III/IV residents.
A total of 1762 consultations were presented at the conference. The consultations were obtained for traumatic injuries, 86.5% (1524/1762); infections, 7.7% (136/1762); and congenital/other problems, 5.8% (102/1762). The 3 most common consultations per rotation were fractures: both-bone forearm (mean, 46.1; range: 24-64), supracondylar humerus (mean, 23.8; range: 17-31), and distal radius (mean, 13.8; range: 7-33). Less common consultations per rotation were septic arthritis (mean, 1.6; range: 0-5), child abuse (mean, 1.3; range: 0-5), Monteggia fracture (mean, 0.3; range: 0-1), compartment syndrome (mean, 0.2; range: 0-1) and patella sleeve fracture (mean, 0.1; range: 0-1).
There was a large disparity between conditions in the number of times presented and reviewed within a 3-month rotation at the daily case conference, with some important conditions not being discussed at all in each rotation. This finding documents a disadvantage of case conferences based on limiting discussion to current patients, and highlights an opportunity for educational improvement.
评估病例会议上呈现的疾病分布情况，以评估住院医师在急性儿科骨科疾病方面的教育暴露程度。
对 3 年内每天儿科骨科病例会议上呈现的急诊和住院咨询进行回顾性分析。咨询被分为 3 个月的住院医师轮转块进行分析。
美国南部的一家三级儿童医院，该医院为 2 个骨科住院医师培训项目的住院医师提供服务。
病例会议由小儿骨科医生、1 名小儿骨科研究员和 4 名 PGY III/IV 住院医师参加。
会议共呈现了 1762 次咨询。咨询的疾病包括创伤性损伤，占 86.5%（1524/1762）；感染，占 7.7%（136/1762）；和先天性/其他问题，占 5.8%（102/1762）。每个轮转周期最常见的 3 次咨询是骨折：双骨前臂（平均，46.1；范围：24-64）、肱骨髁上（平均，23.8；范围：17-31）和桡骨远端（平均，13.8；范围：7-33）。每个轮转周期较少见的咨询是化脓性关节炎（平均，1.6；范围：0-5）、儿童虐待（平均，1.3；范围：0-5）、Monteggia 骨折（平均，0.3；范围：0-1）、间隔综合征（平均，0.2；范围：0-1）和髌骨套骨折（平均，0.1；范围：0-1）。
在每日病例会议上，一个 3 个月的轮转周期中呈现和审查的疾病数量存在很大差异，有些重要的疾病在每个轮转周期中根本没有讨论。这一发现记录了基于限制当前患者讨论的病例会议的一个劣势，并突出了教育改进的机会。
