Moran Elizabeth D, Hsu Deborah, Wisbon Mary, Camp Elizabeth A, Duncan Ellen, Elkarim Alaa, Ellington Aimee Baer, Graff Danielle, Mangold Karen A, McVety Katherine, Nagler Joshua, Patel Lina, Sagalowsky Selin T, Thompson Amy D, Vu Tien T, Yang Cheryl, Sampayo Esther M
Baylor College of Medicine, Houston, TX.
Stanford University School of Medicine, Department of Emergency Medicine, Palo Alto, CA.
Pediatr Emerg Care. 2025 Jul 1;41(7):566-572. doi: 10.1097/PEC.0000000000003377. Epub 2025 May 6.
Pediatric Emergency Medicine (PEM) fellows are expected to perform many procedures during their fellowship, but they often have limited opportunities to practice rare procedures. The number of procedures required to achieve competence remains unclear; however, research suggests that increased practice correlates with skill development. The objective of this study is to quantify the frequency of procedures performed by fellows. Also, we describe how programs currently track their trainees' experiences.
This was a retrospective, multicenter, cross-sectional, descriptive study exploring procedures performed by PEM fellows enrolled in ACGME-accredited programs between July 2019 and June 2020. Fellow and program demographics were collected. We analyzed procedural tracking collected through self-reported logs and documentation within the electronic medical record. In addition, we explored how programs currently track these experiences. Procedures were standardized based on the ACGME list of required procedures.
Eleven fellowship programs submitted the self-reported procedure logs of 104 fellows. Of those, 2 sites reported electronic medical record-based logs. The most frequently documented procedures included medical and trauma resuscitations, procedural sedations, and intubations. The most infrequently reported were nasal packing for nosebleeds and cardiac pacing. Most participating programs tracked experiences through fellow self-report and many offer opportunities for faculty to assess competence.
PEM fellows do not consistently report performing all ACGME-required procedures during the fellowship. In addition, there is significant variation in how fellowship programs track trainees' procedural experiences. This study may inform the development of supplemental educational curricula and the potential revision of the ACGME list of required procedures. Future research could focus on assessing procedural competence.
儿科急诊医学（PEM）专科住院医师在其专科培训期间需要进行多种操作，但他们练习罕见操作的机会通常有限。达到熟练水平所需的操作数量尚不清楚；然而，研究表明，增加练习与技能发展相关。本研究的目的是量化专科住院医师进行操作的频率。此外，我们描述了各培训项目目前如何跟踪其学员的经历。
这是一项回顾性、多中心、横断面描述性研究，探讨了2019年7月至2020年6月期间参加美国研究生医学教育认证委员会（ACGME）认证项目的PEM专科住院医师所进行的操作。收集了专科住院医师和培训项目的人口统计学数据。我们分析了通过自我报告日志和电子病历中的文档收集的操作记录。此外，我们还探讨了各培训项目目前如何跟踪这些经历。操作根据ACGME要求的操作列表进行了标准化。
11个专科培训项目提交了104名专科住院医师的自我报告操作日志。其中，有2个机构报告了基于电子病历的日志。记录最频繁的操作包括医疗和创伤复苏、程序性镇静和插管。报告最少的是鼻出血的鼻腔填塞和心脏起搏。大多数参与项目通过专科住院医师的自我报告来跟踪经历，许多项目还为教员提供评估能力的机会。
PEM专科住院医师在专科培训期间并未始终如一地报告进行了ACGME要求的所有操作。此外，各专科培训项目跟踪学员操作经历的方式存在很大差异。本研究可为补充教育课程的开发以及ACGME要求操作列表的潜在修订提供参考。未来的研究可侧重于评估操作能力。
