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Unique Challenges Faced by Pediatric Residents Essay

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Pediatric residents face unique challenges when learning to perform pediatric procedures due to anatomical, physiological, and behavioral differences. Procedural skills are an essential skill as new medical school graduates enter the patient care setting. Traditionally, this training has involved the “see one, do one, teach one” model. However, with the increasing focus on patient safety this is no longer acceptable.
The Accreditation Council for Graduate Medical Education (ACGME) requires pediatric residencies to provide sufficient training in 14 procedures (Table 1) and that residents should be monitored by the residency program for appropriate skill development. In a 2007 report, Gaies et al1 found that fewer than 65% of pediatrics program directors reported that all or almost all of their residents were competent to perform the following ACGME required procedures at the completion of training: intravenous (IV) placement (48%), arterial puncture (51%), umbilical arterial catheter placement (55%), umbilical venous catheter placement (57%), intubation (60%), and venipuncture (61%). In another study, Leone et al2 reported that the median success rates of neonatal intubations were 33% for pediatric level (PL)1 residents and 40% for PL2 and PL3 residents. Many residency programs are now looking to develop innovative and adequate opportunities to improve procedural skill competency.
Simulation Based Medical Education has been shown to provide opportunities to practice procedural skills and make errors without
harming patients in a safe and controlled environment.3 It is specifically designed to be learner-centered rather than patient- centered. With live patients, learning time is often limited, and access is dependent on pers...


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... improvement in care. Furthermore, the “usefulness” was measured one month and one year after the workshop, and it is not known how this compares to the immediate views and whether the information from skills lab was actually retained or retaught.
Overall, we believe that Simulation Procedural Skills Training was seen to be an effective method of teaching pediatric procedures as perceived by the Residents. The results of the survey and feedback show that time and focus can be redirected for PGY-1 residents to focus on the more likely performed skills in order to improve clinical performance and confidence. Future studies may evaluate retention rates and clinical success rates as the relate to an improvement in patient care and the development of a curriculum to provide upper level residents with more procedural skills training and practice to develop competency.



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