Toto Regina L, Delgado Eva M, Ketterer Tara, Berner Emily, Landau Sarah I, Crowe Molly, Monroig Angeliz Caro, Haghighat Gillian Sedigh, Mollen Cynthia J
Children's Hospital of Philadelphia Philadelphia Pennsylvania USA.
University of Pennsylvania Philadelphia Pennsylvania USA.
AEM Educ Train. 2024 Oct 29;8(5):e11038. doi: 10.1002/aet2.11038. eCollection 2024 Oct.
Emergency physicians care for most children presenting to U.S. emergency departments (EDs). Pediatric exposure during emergency medicine (EM) residency can be variable and critically ill children are rarely encountered. A recent needs assessment revealed that emergency physicians feel less prepared to manage various conditions in children and that infants, regardless of presenting complaint, pose particular challenges. Emergency physician perceptions of the experience of caring for pediatric patients have not been widely examined through a qualitative lens.
We designed an interview-based qualitative study to explore emergency physician perspectives on pediatric patient care. We recruited emergency physicians who graduated from residency in 2015-2019 and all rotated through the same large tertiary children's hospital. Four trained interviewers conducted in-depth, one-on-one virtual interviews. An interdisciplinary team transcribed and then coded the interviews. The team performed a conventional content analysis for themes. Recruitment continued until thematic saturation was achieved.
Twelve participants completed interviews. These participants trained in five diverse residency programs. Likewise, the participants now practice in a variety of settings. Three major themes emerged from the data: (1) experience and exposure are key to establishing comfort caring for children; (2) simulation, pathways, and the pediatric anesthesia rotation are educationally useful; and (3) caring for children poses unique emotional challenges. Participants shared many recommendations for future pediatric education for EM trainees, including increasing autonomy and exposure to neonates and considering how care might differ in a community setting.
This interview-based qualitative study elucidates key themes in recently graduated emergency physicians' perceived experience of caring for children. Our findings have important educational implications for this group of emergency physicians and those who share similar experiences in training and practice.
在美国急诊科就诊的大多数儿童由急诊医生诊治。急诊医学（EM）住院医师培训期间接触儿科患者的机会可能各不相同，且很少遇到危重症儿童。最近的一项需求评估显示，急诊医生感觉在处理儿童的各种病症时准备不足，而且无论就诊主诉如何，婴儿都带来特别的挑战。急诊医生对照顾儿科患者经历的看法尚未通过定性研究进行广泛探讨。
我们设计了一项基于访谈的定性研究，以探讨急诊医生对儿科患者护理的看法。我们招募了2015 - 2019年完成住院医师培训且都曾在同一家大型三级儿童医院轮转的急诊医生。四名经过培训的访谈者进行了深入的一对一虚拟访谈。一个跨学科团队对访谈进行转录，然后进行编码。该团队对主题进行了常规内容分析。持续招募直至达到主题饱和。
12名参与者完成了访谈。这些参与者在五个不同的住院医师培训项目中接受过培训。同样，参与者现在在各种环境中执业。数据中出现了三个主要主题：（1）经验和接触是建立照顾儿童信心的关键；（2）模拟、路径和儿科麻醉轮转在教育方面很有用；（3）照顾儿童带来独特的情感挑战。参与者分享了许多关于未来为急诊医学实习生提供儿科教育的建议，包括增加自主权和接触新生儿的机会，以及考虑在社区环境中护理可能有何不同。
这项基于访谈的定性研究阐明了刚毕业的急诊医生在照顾儿童方面的感知经历中的关键主题。我们的研究结果对这组急诊医生以及在培训和实践中有类似经历的人具有重要的教育意义。
