From the Indiana University School of Medicine/Riley Hospital for Children.
Seattle Children's Hospital.
Pediatr Emerg Care. 2024 Aug 1;40(8):591-597. doi: 10.1097/PEC.0000000000003216. Epub 2024 May 30.
The majority of pediatric patients in the United States (US) are evaluated and treated at general emergency departments. It is possible that discrepancies in length of emergency medicine (EM) residency training may allow for variable exposure to pediatric patients, critical resuscitations, and didactic events. The goal of this pilot study was to compare leadership skills of graduating EM residents from 3- to 4-year programs during simulated pediatric resuscitations using a previously validated leadership assessment tool, the Concise Assessment of Leader Management (CALM).
This was a prospective, multicenter, simulation-based cohort pilot study that included graduating 3 rd - and 4 th -year EM resident physicians from 6 EM residency programs. We measured leadership performance across 3 simulated pediatric resuscitations (sepsis, seizure, cardiac arrest) using the CALM tool and compared leadership scores between the 3 rd - and 4 th -year resident cohorts. We also correlated leadership to self-efficacy scores.
Data was analyzed for 47 participating residents (24 3 rd -year residents and 23 4 th -year residents). Out of a total possible CALM score of 66, residents from 3-year programs scored 45.2 [SD ± 5.2], 46.8 [SD ± 5.0], and 46.6 [SD ± 4.7], whereas residents from 4-year programs scored 45.5 [SD ± 5.2], 46.4 [SD ± 5.0], and 48.2 [SD ± 4.3] during the sepsis, seizure, and cardiac arrest cases, respectively. The mean leadership score across all 3 cases for the 3-year cohort was 46.2 [SD ± 4.8] versus 46.7 [SD ± 4.5] ( P = 0.715) for the 4-year cohort.
These data show feasibility for a larger cohort project and, while not statistically significant, suggest no difference in leadership skills between 3 rd - and 4 th -year EM residents in our study cohort. This pilot study provides the basis of future work that will assess a larger multicenter cohort with the hope to obtain a more generalizable dataset.
美国（US）大多数儿科患者在综合急诊部接受评估和治疗。急诊医学（EM）住院医师培训时间的差异可能导致儿科患者、危急复苏和教学活动的接触机会不同。本研究的目的是使用先前验证的领导力评估工具简明领导管理评估（CALM）比较 3 年制和 4 年制项目的毕业 EM 住院医师在模拟儿科复苏中的领导技能。
这是一项前瞻性、多中心、基于模拟的队列试点研究，纳入了来自 6 个 EM 住院医师培训项目的 3 年级和 4 年级 EM 住院医师。我们使用 CALM 工具在 3 次模拟儿科复苏（脓毒症、癫痫发作、心脏骤停）中测量领导力表现，并比较 3 年级和 4 年级住院医师队列之间的领导力评分。我们还将领导力与自我效能评分相关联。
对 47 名参与的住院医师（24 名 3 年级住院医师和 23 名 4 年级住院医师）进行了数据分析。在 CALM 总分 66 分中，3 年制项目的住院医师得分为 45.2 [标准差 ± 5.2]、46.8 [标准差 ± 5.0]和 46.6 [标准差 ± 4.7]，而 4 年制项目的住院医师得分为 45.5 [标准差 ± 5.2]、46.4 [标准差 ± 5.0]和 48.2 [标准差 ± 4.3]，分别在脓毒症、癫痫发作和心脏骤停病例中。3 年级队列在所有 3 个病例中的平均领导力得分为 46.2 [标准差 ± 4.8]，而 4 年级队列为 46.7 [标准差 ± 4.5]（P = 0.715）。
这些数据表明，对于更大的队列项目具有可行性，虽然没有统计学意义，但在我们的研究队列中，3 年级和 4 年级 EM 住院医师的领导技能没有差异。这项试点研究为未来评估更大的多中心队列提供了基础，希望获得更具普遍性的数据集。
