Abstract

BackgroundThe transport of critically ill patients to children’s hospitals is essential to current practice. The AAP Section on Transport Medicine has raised concerns about future leadership in the field as trainees receive less exposure to transport medicine. This study identifies the priorities of pediatric subspecialty fellows, fellowship directors and nursing directors in transport medicine education.MethodsInternet based surveys were distributed to fellows, fellowship directors and nursing directors of transport teams affiliated with ACGME-approved fellowships in Neonatal-Perinatal Medicine (NPM), Pediatric Critical Care Medicine (PCCM), and Pediatric Emergency Medicine (PEM). Data collection occurred November 2013 to March 2014.ResultsFour hundred and sixty-six responses were collected (357 fellows, 82 directors, 27 nursing directors): Six curricular elements were ranked by respondents: Transport Physiology (TP), Medical Control (MC), Vehicle Safety (VS), Medicolegal Issues (ML), Medical Protocols (MP) and State and Federal Regulations (SFR). Fellows and fellowship directors were not significantly different: TP (p = 0.63), VS (p = 0.45), SFR (p = 0.58), ML (p = 0.07), MP (p = 0.98), and MC (p = 0.36). Comparison of subspecialties found significant differences: PEM considered TP less important than NPM and PCCM (p < 0.001, p < 0.001), VS less important than NPM (p = 0.001). PEM viewed SFR and MC more important than PCCM (p = 0.006, p = 0.002); ML more important than PCCM and NPM (p = 0.001, p < 0.001). PCCM ranked MC more important than NPM (p = 0.004). Nursing directors considered TP less important than NPM and PCCM (p < 0.001, p = 0.002).ConclusionsWhen ranking curricular elements in transport medicine, fellows and fellowship directors do not differ, but comparison of subspecialties notes significant differences. A fellow curriculum in transport medicine will utilize these results.

Highlights

  • The transport of critically ill patients to children’s hospitals is essential to current practice

  • We aimed to describe the current state of education in transport medicine. This survey was designed as an online, prospective, cross sectional survey of three different groups of stakeholders for neonatal and pediatric transport medicine: nursing directors of transport teams affiliated with academic medical centers, fellows in pediatric subspecialties (Neonatal-Perinatal Medicine, Pediatric Critical Care Medicine, Pediatric Emergency Medicine) and fellowship directors in these same subspecialties

  • To accomplish the primary aim of the study, a survey was conducted with a forced ranking of six elements of transport medicine for a proposed curriculum, transport physiology (TP), vehicle safety (VS), State and Federal Regulations (SFR), medicolegal issues (ML), medical protocols (MP) and principles of medical control (MC)

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Summary

Introduction

The transport of critically ill patients to children’s hospitals is essential to current practice. Transport of critically ill and injured infants and children is a crucial component of current pediatric practice. Previous Accreditation Council of Graduate Medical Education (ACGME) requirements for pediatric residents specify “participation in pre-hospital management and transport” as a component of training in treating acutely ill and injured children [4]. It is clear that pediatric residents do not receive uniform exposure to transport medicine. This is noted by the American Academy of Pediatrics Section on Transport Medicine (AAP SOTM) 2013 Consensus Statement on Interfacility Transport: Mickells et al BMC Pediatrics (2017) 17:13

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