Division of Cardiology, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Division of Neonatology, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
J Perinatol. 2024 Aug;44(8):1186-1192. doi: 10.1038/s41372-024-01986-4. Epub 2024 May 20.
The topic of neonatal cardiovascular care in neonatal-perinatal medicine (NPM) fellowship training has continued to transform due to increased complexity of patients, development of specialized units, continued Accreditation Council for Graduate Medical Education requirements, and clinical practice variation across centers that care for neonates with congenital heart disease (CHD).
We developed a neonatal cardiac curriculum comprised of eight interactive sessions with novel active learning concepts specific to our NPM fellows. A self-assessment survey in comfort in managing infants with CHD and perceived competency in neonatal cardiology topics was performed by all neonatology fellows at baseline and after completion of the curriculum. The American Board of Pediatrics Subspecialty In-training Exam (SITE) scores for fellows were compared to that of the national average.
The average comfort score (0-100) of the first-year fellows increased from 33 to 76, and that of the second and third-year fellows increased from 72 to 86, and 75 to 86, respectively. The first-year fellows improved their competency score by 44 points (3 standard deviations), the second-year fellows improved their score by about 26 points (one standard deviation), and there was an overall 9-point increase in the competency score of all fellows (one standard deviation). The average local SITE score was lower than the national average before the initiation of this curriculum, became nearly equal to the national average score at the end of the first year the curriculum was implemented, and has progressively become higher since then.
Due to the variable clinical exposure and differing practice models of managing CHD a neonatal cardiac curriculum may be beneficial to NPM trainees.
由于患者病情的复杂性增加、专科病房的发展、继续满足毕业后医学教育认证委员会（Accreditation Council for Graduate Medical Education）的要求以及不同中心对先天性心脏病（CHD）新生儿护理的临床实践差异，新生儿围产医学（neonatal-perinatal medicine，NPM）研究员培训中的新生儿心血管护理这一主题不断发生转变。
我们为 NPM 研究员制定了一个包含 8 个互动环节的新生儿心脏课程，其中包含了一些专门针对我们的学员的新颖的主动学习概念。在课程开始前和结束后，所有新生儿科研究员都通过自我评估调查，对自己管理 CHD 婴儿的舒适度和对新生儿心脏病学主题的认知能力进行了评估。我们比较了研究员的美国儿科学会专科住院医师培训考核（Subspecialty In-training Exam，SITE）成绩与全国平均水平。
第一年的研究员的平均舒适度评分（0-100）从 33 增加到 76，第二年和第三年的研究员分别从 72 增加到 86，从 75 增加到 86。第一年的研究员的认知能力评分提高了 44 分（3 个标准差），第二年的研究员提高了约 26 分（1 个标准差），所有研究员的认知能力评分整体提高了 9 分（1 个标准差）。在开始这一课程之前，当地的 SITE 平均分数低于全国平均水平，在实施该课程的第一年结束时，分数几乎与全国平均水平持平，此后，分数逐渐提高。
由于管理 CHD 的临床经验和实践模式存在差异，新生儿心脏课程可能对 NPM 学员有益。
