83 Pediatric Resident Perspectives on a Procedure Day Pilot Program

Abstract

Abstract Background Royal College objectives emphasize the importance of competencies in lumbar punctures (LPs) amongst pediatric trainees. While a relatively common procedure in pediatrics, studies show that skills decay over time and that trainees may experience uncertainty and variable success rates in performing LPs. Unsuccessful LPs can lead to increased treatment costs, inappropriate antibiotic use, and patient morbidity. Further, the Hematology/Oncology department at our centre has diagnostic and therapeutic LPs that are performed under procedural sedation weekly and do not always have a learner in attendance. Objectives To implement an initiative in a pediatric residency program allowing residents to sign up for these procedure days. The goals of this initiative were to provide additional opportunities in a safe, controlled, and well-supervised setting to improve LP competence and confidence amongst residents. In addition, we can use this to develop a formal procedural curriculum in our program. Design/Methods A pilot proposal was presented to all stakeholders (program leadership and hematology/oncology departments) for approval. Residents were then able to sign up for twice-weekly procedure days to enhance LP skills. Following the pilot, residents were sent a questionnaire to assess their perceptions of the initiative and skill enhancement using a 5-point Likert scale. With the second iteration of this initiative due to start in 2022, we will be using pre- and post-procedure day surveys to further assess self-reported improvement in various domains. Results A total of 14 residents signed up for 42% of eligible days (range of 1-4 days per resident). Total number of LPs ranged from 2-20 per resident over the pilot. All respondents agreed that the initiative was useful in improving their technical skills and confidence. 91% of respondents strongly agreed this pilot should continue to be implemented in the program. Conclusion This educational initiative successfully improved resident perceptions of LP skills. Residents felt they were more confident and skillful after this enhanced educational opportunity.