Pediatric Residents
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2021 ◽  
Vol Publish Ahead of Print ◽  
Shannon S. Wai ◽  
Atim Uya ◽  
Elise Zimmerman ◽  
Kristin Ratnayake ◽  
Kathryn Hollenbach ◽  

2021 ◽  
pp. 000992282110352
Hannah Barber Doucet ◽  
Valerie L. Ward ◽  
Tiffani J. Johnson ◽  
Lois K. Lee

The objective of this study was to determine the attitudes, skill level, and preferred educational interventions of pediatric residents related to implicit bias and caring for diverse patient populations. A cross-sectional survey of pediatric residents at a single, large urban residency program was utilized. Surveys were completed by 88 (55%) residents who were 69% female and 35% non-White or mixed race. Almost all residents felt that it was very or extremely important to receive training on health disparities, diverse patient populations, and implicit bias. Self-assessment of skill level revealed that residents felt confident in areas often covered by cultural competency curricula, such as interpreter use, but were less confident in other areas. The top 3 areas identified for further training included implicit bias, working with transgender and gender nonconforming patients, and weight bias. For the majority of diversity and bias-related skills, prior training was significantly correlated with higher skill level ( P < .05).

Brian C. Gin ◽  
Stephanie Tsoi ◽  
Leslie Sheu ◽  
Karen E. Hauer

Abstract Introduction Trust between supervisors and trainees mediates trainee participation and learning. A resident (postgraduate) trainee’s understanding of their supervisor’s trust can affect their perceptions of their patient care responsibilities, opportunities for learning, and overall growth as physicians. While the supervisor perspective of trust has been well studied, less is known about how resident trainees recognize supervisor trust and how it affects them. Methods In this qualitative study, 21 pediatric residents were interviewed at a single institution. Questions addressed their experiences during their first post-graduate year (PGY-1) on inpatient wards. Each interviewee was asked to describe three different patient care scenarios in which they perceived optimal, under-, and over-trust from their resident supervisor. Data were analyzed using thematic analysis. Results Residents recognized and interpreted their supervisor’s trust through four factors: supervisor, task, relationship, and context. Optimal trust was associated with supervision balancing supervisor availability and resident independence, tasks affording participation in decision-making, trusting relationships with supervisors, and a workplace fostering appropriate autonomy and team inclusivity. The effects of supervisor trust on residents fell into three themes: learning experiences, attitudes and self-confidence, and identities and roles. Optimal trust supported learning via tailored guidance, confidence and lessened vulnerability, and a sense of patient ownership and team belonging. Discussion Understanding how trainees recognize supervisor trust can enhance interventions for improving the dialogue of trust between supervisors and trainees. It is important for supervisors to be cognizant of their trainees’ interpretations of trust because it affects how trainees understand their patient care roles, perceive autonomy, and approach learning.

Nancy M. Tofil ◽  
Stacy L. Gaither ◽  
Charli Cohen ◽  
Carrie Norwood ◽  
Jerry Lynn Zinkan ◽  

AbstractPediatric advanced life support (PALS) training is critical for pediatric residents. It is unclear how well PALS skills are developed during this course or maintained overtime. This study evaluated PALS skills of pediatric interns using a validated PALS performance score following their initial PALS certification. All pediatric interns were invited to a 45-minute rapid cycle deliberate practice (RCDP) training session following their initial PALS certification from July 2017 to June 2019. The PALS score and times for key events were recorded for participants prior to RCDP training. We then compared performance scores for those who took PALS ≥3 months, between 3 days to 3 months and 3 days after PALS. There were 72 participants, 30 (of 30) in 3 days, 18 in 3 days to 3 months, and 24 in ≥3 months groups (42 total of 52 residents, 81%). The average PALS performance score was 53 ± 20%. There was no significant difference between the groups (3 days, 53 ± 15%; 3 days–3 months, 51 ± 19%; ≥3 months, 54 ± 26%, p = 0.922). Chest compressions started later in the ≥3 months groups compared with the 3 days or ≤3 months groups (p = 0.036). Time to defibrillation was longer in the 3 days group than the other groups (p = 0.008). Defibrillation was asked for in 3 days group at 97%, 73% in 3 days to 3 months and 68% in ≥3 months groups. PALS performance skills were poor in pediatric interns after PALS certification and was unchanged regardless of when training occurred. Our study supports the importance of supplemental resuscitation training in addition to the traditional PALS course.

Kaitlyn Boggs ◽  
Tress Goodwin ◽  
Joelle Simpson

Abstract Objective: Assess the knowledge, confidence, and attitudes of residents towards disaster medicine education in the COVID-19 era. Methods: Survey distributed to pediatric residents at a tertiary care center, assessing confidence in disaster medicine knowledge and skills and preferred educational methods. Based on residents’ responses, virtual and in-person educational session implemented with post-survey to analyze effectiveness of education. Results: Distributed to 120 residents with a 51.6% response rate. Almost half (46.8%) of residents had less than 1 hour of disaster training, with only 9.7% having experience with a prior disaster event. However, most residents were motivated to increase their knowledge of disaster medicine due to COVID-19 and other recent disasters, with 96.8% interested in this education as a curriculum standard. Simulation and peer learning were the most preferred method of teaching. Subsequent virtual and in-person educational session demonstrated improvement in confidence scores. However, 66.7% of the virtual subset conveyed they would have preferred in-person learning. Conclusion: COVID-19 has highlighted to trainees that disasters can affect all specialties, and pediatric residents are enthusiastic to close the educational gap of disaster medicine. However, residents stressed that although virtual education can provide a foundation, in-person simulation is preferred for effective training.

2021 ◽  
pp. e2020026666
Kimberly Montez ◽  
Emma A. Omoruyi ◽  
Kenya McNeal-Trice ◽  
Wendy J. Mack ◽  
Lahia Yemane ◽  

Amar Taksande ◽  
Rupesh Rao ◽  
Sachin Yedve ◽  
Patel Zeeshan Jameel ◽  
Revat Meshram

Background: Planter reflex is still an essential part of the neurological examination. The usual plantar reflex involved bending of the big toe or no response. There is a positive Babinski signal with corticospinal dysfunction, which involves big toe dorsal flexion and the accompanying fanning of the other toes. It’s one of the infant reflexes that disappers as the infant nervous system grows. The plantar reaction is primarily extensive in stable, term neonates. Many have researched this reflex's accuracy but very few studies have analyzed the various techniques of the planting reflex. Objective: To assess the five different technique of eliciting the plantar reflex in newborn babies. Materials and Methods: In this cross-sectional study, the eligible healthy newborn will be given the different methods for the elicitation of the plantar reflex i.e. Oppenheim sign, Gordon sign, Gonda’s sign, Chaddock sign, and Schaefer sign. During this procedure, we will record  the baseline RR, HR, and SpO2 before, and after the procedure. Three pediatric residents of the different years will be selected for examining the newborn reflexes throughout the study period. Results: After completion of the study, we will come to know the negative likelihood ratio, negative predictive value, positive predictive, specificity, positive likelihood ratio, and sensitivity of the Oppenheim sign, Gordon sign, Gonda’s sign, Chaddock sign, and Schaefer sign. Conclusion: The study will probably give us information about the sensitivity and specificity of the Oppenheim sign, Gordon sign, Gonda’s sign, Chaddock sign, and Schaefer sign for the elicitation of the plantar reflex in the neonates.

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