Burns Rebekah A, Uspal Neil G
From the Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Washington and Seattle Children's Hospital, Seattle, WA.
Pediatr Emerg Care. 2020 Apr;36(4):e180-e184. doi: 10.1097/PEC.0000000000001362.
The aims of this study were to determine current practices in procedural training and skill assessment for attending physicians working in pediatric emergency departments within the United States and Canada and identify barriers to providing training and assessment.
This was a cross-sectional survey study. Members of the pediatric emergency medicine fellowship program directors and associate program directors Listserv were invited to participate in an anonymous survey about attending physician training and assessment practices for 9 specific procedures and barriers to training and assessment.
Eighty-two (56.2%) of 146 recipients responded, with 79 surveys fully completed; 58.5% of responders report that their division offers procedural training, whereas 14.6% report assessment of procedural skills. The most common procedure for which participants report training and assessment is orotracheal intubation (53.1% and 7.5%, respectively), with training rates for other procedures ranging from 2.5% to 43.0%. Most sites that report training use simulation in some form for education. For assessment, simulation is used almost exclusively. Cost (50.6%), lack of faculty interest (36.7%), and lack of standardized guidelines (36.7%) are the most common barriers to training. Lack of standardized guidelines (51.9%), cost (43.0%), and lack of faculty interest (38.0%) are the most common barriers for assessment.
Although pediatric emergency medicine physicians may be required to perform emergent procedures, opportunities to receive training and assessment in these procedures are limited. Simulation and other educational modalities are being used to provide skill training and assessment, but cost and lack of resources, standardized protocols, and faculty interest are barriers to the implementation of training and assessment programs.
本研究旨在确定美国和加拿大儿科急诊科主治医生在程序培训和技能评估方面的当前做法，并找出提供培训和评估的障碍。
这是一项横断面调查研究。邀请儿科急诊医学 fellowship 项目主任和副主任项目主任邮件列表的成员参与一项关于主治医生 9 种特定程序培训和评估做法以及培训和评估障碍的匿名调查。
146 名收件人中有 82 人（56.2%）回复，79 份调查问卷完全完成；58.5%的回复者报告称其科室提供程序培训，而 14.6%报告进行程序技能评估。参与者报告进行培训和评估的最常见程序是气管插管（分别为 53.1%和 7.5%），其他程序的培训率在 2.5%至 43.0%之间。大多数报告提供培训的场所某种程度上使用模拟进行教育。对于评估，几乎完全使用模拟。成本（50.6%）、教员缺乏兴趣（36.7%）和缺乏标准化指南（36.7%）是培训最常见的障碍。缺乏标准化指南（51.9%）、成本（43.0%）和教员缺乏兴趣（38.0%）是评估最常见的障碍。
尽管儿科急诊医学医生可能需要进行紧急程序，但接受这些程序培训和评估的机会有限。模拟和其他教育方式正在用于提供技能培训和评估，但成本以及缺乏资源、标准化方案和教员兴趣是培训和评估计划实施的障碍。
