Bukeyeneza Jocelyne, Goyal Medha, Bilgic Elif, MacKenzie Katelyn, Aziz Mohammad Omar, El Tobgy Kamal, Goswami Ipsita
Department of Pediatrics, McMaster Children's Hospital, McMaster University, Ontario, ON, Canada.
St Catherine's General Hospital, Hamilton Health Sciences, Ontario, ON, Canada.
J Eval Clin Pract. 2025 Jun;31(4):e70112. doi: 10.1111/jep.70112.
Neonatal encephalopathy (NE), particularly due to hypoxia/ischemia at birth, is a perinatal emergency. Timely diagnosis and initiation of therapeutic hypothermia within a 6-h window from birth are challenging.
We aimed to explore the challenges community physicians face in the management of NE in our region and to test the feasibility of co-designing and implementing an educational program that addresses their needs.
This mixed-method study started with a 1 h semi-structured interview with community pediatricians through an audio-recorded virtual platform. Subsequently, an outreach training workshop was designed and pilot-tested at each participating center.
Qualitative analysis included the following steps: data familiarization, code and theme generation, and report writing. Descriptive statistics were used to summarize the impact of the curriculum on participants' knowledge and experience.
Key themes included lack of experience with detailed neurological examination due to infrequent exposure, lack of standardization in management guidelines, and limited access to brain monitoring devices. Diagnosing NE was challenging due to the natural variability in presentation, progression and time-sensitiveness of interventions. Focused skill development workshops were found to be feasible and significantly improved participants' knowledge of NE. Almost 75% of the participants perceived that the workshop enhanced their comfort levels with the neonatal neurological assessment.
Outreach training education adapted to the local context is feasible and essential for the skill maintenance of community pediatricians who infrequently encounter NE. Future studies will have to study the impact of such workshops on physician behavior and patient outcomes.
新生儿脑病（NE），尤其是由于出生时缺氧/缺血导致的，是一种围产期急症。在出生后6小时内及时诊断并开始治疗性低温治疗具有挑战性。
我们旨在探讨社区医生在我们地区管理NE时面临的挑战，并测试共同设计和实施一个满足他们需求的教育项目的可行性。
这项混合方法研究首先通过音频录制的虚拟平台对社区儿科医生进行了1小时的半结构化访谈。随后，设计了一个外展培训工作坊并在每个参与中心进行了试点测试。
定性分析包括以下步骤：数据熟悉、代码和主题生成以及报告撰写。描述性统计用于总结课程对参与者知识和经验的影响。
关键主题包括由于接触频率低而缺乏详细神经学检查的经验、管理指南缺乏标准化以及脑监测设备的获取有限。由于临床表现、进展和干预的时间敏感性存在自然变异性，诊断NE具有挑战性。发现有针对性的技能发展工作坊是可行的，并且显著提高了参与者对NE的知识。几乎75%的参与者认为该工作坊提高了他们在新生儿神经学评估方面的舒适度。
适应当地情况的外展培训教育对于很少遇到NE的社区儿科医生的技能维持是可行且必不可少的。未来的研究将不得不研究此类工作坊对医生行为和患者结局的影响。
