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Objectives: To describe an educational program for pediatric house staff who participate in interhospital transport and present an evaluation of the educational program. Design: Educational program evaluation that used multiple confidential surveys of participating pediatric house staff. Setting: The interhospital transport team of a large, urban pediatric hospital. Participant' Twenty-six pediatric second-year residents who participated in required rotations with the transport service. Intervention: The institution an educational program designed specifically for the clinical transport rotation. Results: Before their service with the transport team, residents have doubts about their clinical skills, fund of knowledge, and ability to practice independently in a mobile environment. These doubts decrease as the residents participate in the educational program during their transport clinical service. All residents perceive service on the transport rotation to be of educational benefit with regard to communications or cognitive skills. Alternatively, transport service provides little opportunity for residents to improve technical skills. Among the various skills that residents could obtain during transport service, improvement in clinical judgment was most commonly cited by residents who performed more than 10 transports. Among the specific curricular components in the educational program, interactive teaching methods were judged to be more valuable than written materials. Conclusions: Serving as a physician on interhospital transports can be an important educational opportunity for pediatric house staff when that experience is concentrated in a designated rotation and combined with a focused educational program. Contrary to expectations, there was little opportunity for residents to develop technical skills on transport. Therefore, educators should focus on the development of communications and cognitive skills. Interhospital transport programs that debate the use of residents as members of the service should consider the potential educational benefit of the clinical service to house staff., Interhospital transport rotations appear to be beneficial to pediatric residents in developing communication and judgment skills. These rotations involve attending to pediatric patients and their families during transport from one hospital to another. Researchers surveyed 26 second-year residents before the transport rotation and after each of two blocks of the six-week rotation. The residents itemized their concerns about the program and evaluated the coursework and their own skill levels. Most of the residents (86%), particularly those who made more than 10 transports, ranked improvement in judgment skills as the most beneficial aspect of this rotation. A similar percentage of residents felt comfortable placing an intravenous line before (79%) and after the rotation (79%). Perceptions of skill levels were similar for other technical skills. More residents judged the interaction with teachers as being more helpful than the written materials and felt that this rotation provided the greatest opportunity to improve communication skills.

Objective: To evaluate the effectiveness of an educational intervention on pediatric residents' resuscitation fund of knowledge, technical skills, confidence, and overall performance. Design: Prospective, nonconcurrent, controlled interventional trial. Setting: Urban pediatric tertiary care hospital. Participants: An intervention group (IG) of 28 pediatric residents graduating in 1997, and a control group (CG) of 30 pediatric residents graduating in 1996. Interventions: Resuscitation course with didactic lectures and skills practice stations, as well as a minimum of 3 practice mock resuscitations with immediate feedback throughout postgraduate year 3. Main Outcome Measures: Fund of knowledge, using the Pediatric Advanced Life Support test and short answer test; technical skills, using the Airway and Vascular Access Skills Assessment; experience and confidence, using an anonymous survey; and overall performance, evaluated using a videotaped mock resuscitation test. Results: The IG scored better on the short answer test (P [is less than] .001). A larger number of IG residents were successful in the completion of ancillary airway maneuvers and femoral vascular access (P = .02), as well as endotracheal intubation (P = .004) and intraosseous access (P = .002). The IG was more confident in their leadership role (P = .0001) and technical skills (P = .05). Trends toward improved overall performance were noted for the IG mock resuscitations. Residents in the IG were more likely to assess the airway in fewer than 2 minutes (P = .02), recognize the threat to life in fewer than 5 minutes (P = .02), and complete the primary survey in a timely fashion (P = .05). They required fewer prompts (P = .04) and made fewer mistakes (P = .07). Conclusions: A structured, formal curriculum can improve the necessary fund of knowledge, skills, confidence, and leadership required for resuscitation. Arch Pediatr Adolesc Med. 2000;154:1049-1054

Objective: To develop and pilot test a telephone-based survey instrument that enables parents to identify and characterize the body region and severity of childhood injuries using the Abbreviated Injury Scale (AIS) scoring system. Design: A prospective cross-sectional survey. Selling: The emergency department of an urban, tertiary care, pediatric trauma center. Participants: One hundred forty-seven parents of children younger than 18 years and seen in the emergency department for acute treatment of an unintentional injury. Interventions: None. Main Outcome Measure: The degree of agreement, measured as sensitivity, specificity, and [Kappa] statistic, between medical record information and parents' responses to the telephone survey regarding the identification and characterization of clinically significant (AIS [is greater than or equal to] 2) injuries. Results: The survey, known as the Injury Severity Assessment Survey/Parent Report, was developed via a systematic review of the AIS 1990 manual. Answers to questions were developed in a way that enabled automated coding of responses into AIS scores or ranges of scores. The sensitivity of the survey (its ability to detect injuries scoring 2 or more on the AIS that were documented in the medical record) varied somewhat by the body region of injury, ranging from 88% for head, face, neck, and spine injuries to 95% for extremity injuries. Intermediate sensitivity (92%) was noted for the detection of significant chest and abdomen injuries. The specificity of the survey (its ability to rule out the presence of a significant injury when one was not documented in the medical record) was more than 95% in each of the 3 body region groups. The [Kappa] statistics for the 3 body region groups ranged from 0.89 to 0.92. Conclusions: A new telephone-based survey has been developed that enables parents to characterize their child's injuries by body region and to differentiate between minor injuries and more significant injuries using a well-established injury classification system. This survey has a significant advantage over previous telephone-based or written surveys of childhood injuries and may be particularly valuable in population-based (eg, random-digit dial surveys) or multi-institutional studies of pediatric injuries. Arch Pediatr Adolesc Med. 1999;153:404-408, An injury assessment survey designed to help parents describe accidental injuries in children to medical personnel appears to be useful. Researchers developed the Injury Severity Assessment Survey/Parent Report and tested it with 147 parents visiting emergency departments for injuries to their children. The survey was highly sensitive at quantifying head, face, neck and spine injuries, and moderately sensitive at detecting chest and abdomen injuries. An injury survey may improve research studies on childhood injury.