The Pediatric Internship as a Teaching Technique: A Comparison of Learning Experiences in Five Hospitals

Five interns joined in a collaborative study to assess their learning experiences during the internship year. A 3x5-inch data form was completed for each patient for whom the intern was responsible. Information was gathered on demographic characteristics of the patient, the teaching that involved this patient, and what skills were acquired. Nearly 30% of the patients were under 1 year of age; 55% were boys. More than one half of the contacts were in an outpatient or emergency department. Over 80% of the patients had not been seen before; continuity patients made up less than 9% of the contacts. Well-child care was the largest care category (19%), followed by respiratory problems (15%) and injuries (9%). About 40% of the contacts involved a teaching input, mainly from residents, attending physicians, and faculty. Care skills most frequently acquired were physical examination (49%), reading (15%), and interviewing (11%). Crosstabulations showed that most learning was reported for inpatients, for patients with rare diseases, and when some teaching was involved.

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Routine Emergency Department Use for Sick Care by Children in the United States

PEDIATRICS ◽

10.1542/peds.98.1.28 ◽

1996 ◽

Vol 98 (1) ◽

pp. 28-34 ◽

Cited By ~ 7

Author(s):

Neal Halfon ◽

Paul W. Newacheck ◽

David L. Wood ◽

Robert F. St Peter

Keyword(s):

High School ◽

Emergency Department ◽

Child Care ◽

Emergency Departments ◽

Primary Care Physicians ◽

The United States ◽

Health Maintenance ◽

Well Child Care ◽

Usual Source ◽

Us Children

Background. The use of the emergency departments as a regular source of sick care has been increasing, despite the fact that it is costly and is often an inappropriate source of care. This study examines factors associated with routine use of emergency departments by using a national sample of US children. Methods. Data from the 1988 National Health Interview Survey on Child Health, a nationally representative sample of 17 710 children younger than 18 years, was linked to county-level health resource data from the Area Resource File. Bivariate and multivariate analyses were used to assess the association between children's use of emergency departments as their usual sources of sick care and predisposing need and enabling characteristics of the families, as well as availability of health resources in their communities. Results. In 1988 3.4% or approximately 2 million US children younger than 18 years were reported to use emergency departments as their usual sources of sick care. Significant demographic risk factors for reporting an emergency department as a usual source of sick care included black versus white race (odds ratio [OR], 2.08), single-parent versus two-parent families (OR, 1.53), mothers with less than a high school education versus those with high school or more (OR, 1.76), poor versus nonpoor families (OR, 1.76), and living in an urban versus suburban setting (OR, 1.38). Specific indicators of need, such as recurrent health conditions (asthma, tonsillitis, headaches, and febrile seizures), were not associated with routine use of emergency departments for sick care. Furthermore, health insurance status and specifically Medicaid coverage had no association with use of the emergency department as a usual source of sick care. Compared with children who receive well child care in private physicians' offices or health maintenance organizations, children whose sources of well child care were neighborhood health centers were more likely to report emergency departments for sick care (OR, 2.01). Children residing in counties where the supply of primary care physicians was in the top quintile had half the odds (OR, 0.50) of reporting emergency departments as usual sources of sick care.

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Well-Child Care in Infancy and Emergency Department Use by South Carolina Medicaid Children Birth to 6 Years Old

Southern Medical Journal ◽

10.1097/smj.0b013e31822426c0 ◽

2011 ◽

Vol 104 (8) ◽

pp. 604-608 ◽

Cited By ~ 4

Author(s):

William B. Pittard

Keyword(s):

Emergency Department ◽

South Carolina ◽

Child Care ◽

Emergency Department Use ◽

Well Child Care ◽

Medicaid Children

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Adherence to Well-Child Care and Home Visiting Enrollment Associated with Increased Emergency Department Utilization

Maternal and Child Health Journal ◽

10.1007/s10995-019-02821-5 ◽

2019 ◽

Vol 24 (1) ◽

pp. 73-81 ◽

Cited By ~ 1

Author(s):

Neera K. Goyal ◽

Courtney M. Brown ◽

Alonzo T. Folger ◽

Eric S. Hall ◽

Judith B. Van Ginkel ◽

...

Keyword(s):

Emergency Department ◽

Child Care ◽

Home Visiting ◽

Emergency Department Utilization ◽

Well Child Care

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The Impact of Infant Well-Child Care Compliance and Social Risks on Emergency Department Utilization

Clinical Pediatrics ◽

10.1177/0009922817706145 ◽

2017 ◽

Vol 56 (10) ◽

pp. 920-927 ◽

Cited By ~ 3

Author(s):

Nikki R. Lawson ◽

Melissa D. Klein ◽

Nicholas J. Ollberding ◽

Victoria Wurster Ovalle ◽

Andrew F. Beck

Keyword(s):

Emergency Department ◽

Child Care ◽

Emergency Department Utilization ◽

Well Child Care ◽

Social Risks ◽

The Impact

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Urgent considerations for assessment of coma in the emergency department

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20214043 ◽

2021 ◽

Author(s):

Tammam Mozher Aldarwish ◽

Talal Hussain Alolowi ◽

Rayan Othman Alsadiqi ◽

Hussain Ali Al Hassan ◽

Abdullah Saeed Alqahtani ◽

...

Keyword(s):

Emergency Department ◽

Physical Examination ◽

Treatment Plan ◽

Rapid Assessment ◽

Management Plan ◽

Management Approach ◽

Eyes Absent ◽

Assessment And Evaluation ◽

Evaluation Approaches ◽

Attending Physicians

Not speaking, closed eyes, absent response to tactile, verbal or noxious stimuli are characteristic of comatose patients. Many causes of coma have been identified and reported in the literature. However, other causes might require extensive assessment and evaluation approaches. The attending physicians start with the baseline support of life for the affected patients, followed by rapid assessment and evaluation of the etiology and pathophysiology and adequate physical examination. In addition, it requires imaging and laboratory investigations whenever needed to determine the most appropriate management plan. In this literature review, we have conducted a brief discussion about the urgent considerations for the assessment of coma in the emergency department. Many causes can attribute to the development of coma. Therefore, adequate assessment and evaluation is a key component in the management of the affected patients in the emergency department. Moreover, the management approach might differ based on the underlying etiology. Nevertheless, caring for breathing, circulation, management of the airways, and stabilization are the main steps that should be done for each comatose patient. Physical examination is also critical in such situations, where imaging or conducting laboratory tests might not be suitable for some patients. Finally, the treatment plan should be directed based on the underlying etiology of coma.

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