Cavallaro Sarah C, Schutzman Sara, Li Joyce, Pusic Martin
Division of Emergency Medicine Boston Children's Hospital Boston Massachusetts USA.
AEM Educ Train. 2024 Apr 15;8(2):e10978. doi: 10.1002/aet2.10978. eCollection 2024 Apr.
Currently, the Accreditation Council of Graduate Medical Education requires time-based pediatric experiences for emergency medicine (EM) residents in both pediatric emergency medicine (PEM) and critical care settings. The American Board of Emergency Medicine has published the Model of the Clinical Practice of Emergency Medicine, which is a list of content an EM resident should learn. However, this list is large and without prioritization and therefore can be difficult to incorporate into time-limited curricula.
The primary objective of this study was to develop comprehensive categorization of PEM content using an EM lens. The second objective was to suggest a prioritization for the EM learner of the enumerated PEM elements.
We first assembled a comprehensive list of PEM concepts, diagnoses, and procedures that might be taught to EM residents. We then convened focus groups composed of key stakeholders to help formulate content and concept themes important for EM resident training. Once the themes were identified, we divided the list of PEM topics into appropriate themes and then carried out a second round of focus groups expanded to include more diverse expert input for prioritizing the elements of the comprehensive list within each theme.
We prioritized 168 important PEM concepts from previous standards and emerging PEM literature among 10 identified themes: the pediatric normal, the bottom-line boil-it-down approach, common presentations, high-acuity pediatric cases and procedures, differences between children and adults, same between children and adults, red flags, infrequency of caring for a child compared with an adult, keep breadth but promote self-directed depth, and triage and disposition.
Based on input from stakeholders in EM resident education, we identified key themes within PEM education and created a framework for the hierarchical categorization of PEM content for within an EM residency.
目前，毕业后医学教育认证委员会要求急诊医学（EM）住院医师在儿科急诊医学（PEM）和重症监护环境中积累基于时间的儿科经验。美国急诊医学委员会发布了《急诊医学临床实践模式》，这是一份EM住院医师应学习的内容清单。然而，这份清单内容繁多且没有优先级划分，因此很难纳入时间有限的课程中。
本研究的主要目的是从EM的视角对PEM内容进行全面分类。第二个目的是为EM学习者建议对所列PEM要素的优先级排序。
我们首先汇编了一份可能会教授给EM住院医师的PEM概念、诊断和操作的综合清单。然后，我们召集了由关键利益相关者组成的焦点小组，以帮助制定对EM住院医师培训重要的内容和概念主题。一旦确定了主题，我们将PEM主题清单划分为适当的主题，然后开展第二轮焦点小组讨论，扩大范围以纳入更多样化的专家意见，以便对每个主题内综合清单的要素进行优先级排序。
我们从先前的标准和新兴的PEM文献中，在10个确定的主题中确定了168个重要的PEM概念的优先级：儿科正常情况、底线简化方法、常见表现、高 acuity儿科病例和操作、儿童与成人的差异、儿童与成人的相同之处、危险信号、与成人相比照顾儿童的频率较低、保持广度但促进自主深入学习，以及分诊和处置。
基于EM住院医师教育利益相关者的意见，我们确定了PEM教育中的关键主题，并创建了一个框架，用于在EM住院医师培训中对PEM内容进行分层分类。
