Joyce Li1,2, Genie Roosevelt3, Kerry McCabe4, Jane Preotle5, Faria Pereira6, James K Takayesu7, Michael Monuteaux1,2, Richard G Bachur1,2. 1. Division of Emergency Medicine Boston Children's Hospital Boston MA. 2. Department of Emergency Medicine and Pediatrics Harvard Medical School Boston MA. 3. Denver Health Medical Center Department of Emergency Medicine University of Colorado School of Medicine Denver CO. 4. Boston Medical Center Department of Emergency Medicine Boston University School of Medicine Boston MA. 5. Hasbro Children's Hospital Department of Emergency Medicine Alpert Medical School of Brown University Providence RI. 6. Texas Children's Hospital Division of Emergency Medicine Baylor College of Medicine Houston TX. 7. Massachusetts General Hospital Division of Emergency Medicine Harvard Medical School Boston MA.
Abstract
OBJECTIVE: While emergency medicine (EM) physicians treat the majority of pediatric EM (PEM) patients in the United States, little is known about their PEM experience during training. The primary objective was to characterize the pediatric case exposure and compare to established EM residency training curricula among EM residents across five U.S. residency programs. METHODS: We performed a multicenter medical record review of all pediatric patients (aged < 18 years) seen by the 2015 graduating resident physicians at five U.S. EM training programs. Resident-level counts of pediatric patients were measured and specific counts were classified by the 2016 Model of Clinical Practice of Emergency Medicine (MCP) and Pediatric Emergency Care Applied Research Network (PECARN) diagnostic categories. We assessed variability between residents and between programs. RESULTS: A total of 36,845 children were managed by 68 residents across all programs. The median age was 6 years. The median number of patients per resident was 660 with an interquartile range of 336. The most common PECARN diagnostic categories were trauma, gastrointestinal, and respiratory disease. Thirty-two core MCP diagnoses (43% of MCP list) were not seen by at least 50% of the residents. We found statistically significant variability between programs in both PECARN diagnostic categories (p < 0.01) and MCP diagnoses (p < 0.01). CONCLUSION: There is considerable variation in the number of pediatric patients and the diagnostic case volume seen by EM residents. The relationship between this case variability and competence upon graduation is unknown; further investigation is warranted to better inform program-specific curricula and to guide training requirements in EM.
OBJECTIVE: While emergency medicine (EM) physicians treat the majority of pediatric EM (PEM) patients in the United States, little is known about their PEM experience during training. The primary objective was to characterize the pediatric case exposure and compare to established EM residency training curricula among EM residents across five U.S. residency programs. METHODS: We performed a multicenter medical record review of all pediatric patients (aged < 18 years) seen by the 2015 graduating resident physicians at five U.S. EM training programs. Resident-level counts of pediatric patients were measured and specific counts were classified by the 2016 Model of Clinical Practice of Emergency Medicine (MCP) and Pediatric Emergency Care Applied Research Network (PECARN) diagnostic categories. We assessed variability between residents and between programs. RESULTS: A total of 36,845 children were managed by 68 residents across all programs. The median age was 6 years. The median number of patients per resident was 660 with an interquartile range of 336. The most common PECARN diagnostic categories were trauma, gastrointestinal, and respiratory disease. Thirty-two core MCP diagnoses (43% of MCP list) were not seen by at least 50% of the residents. We found statistically significant variability between programs in both PECARN diagnostic categories (p < 0.01) and MCP diagnoses (p < 0.01). CONCLUSION: There is considerable variation in the number of pediatric patients and the diagnostic case volume seen by EM residents. The relationship between this case variability and competence upon graduation is unknown; further investigation is warranted to better inform program-specific curricula and to guide training requirements in EM.
Authors: B Price Kerfoot; Yineng Fu; Harley Baker; Donna Connelly; Michael L Ritchey; Elizabeth M Genega Journal: J Am Coll Surg Date: 2010-07-13 Impact factor: 6.113
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Authors: Jennie A Buchanan; Patricia Hagan; Taylor McCormick; Genie Roosevelt; W Gannon Sungar; Christy Angerhofer; Richard Byyny; Maria Moreira Journal: West J Emerg Med Date: 2020-11-20