Missed Opportunities During Pediatric Residency Training

Abstract

The Accreditation Council for Graduate Medical Education requires pediatric residency training programs to provide exposure to the prehospital management and transport of patients. The authors hypothesized that compared with a similar study a decade prior, current pediatric residency training programs have reduced requirements for participation in transport medicine, thus reducing further the opportunities for residents to learn the management of critically ill infants and children. In 2009, a questionnaire was distributed to 182 pediatric residency program directors. The authors obtained information regarding the neonatal and pediatric transport teams, the training program size, and the pediatric residents' role in the transport team. Sixty-eight (37%) of the 182 surveyed institutions responded. Residents were involved in neonatal and pediatric transports in 42.8% and 55.0% of programs, respectively. When involved in transports, residents were the neonatal and pediatric team leaders 44.4% and 42.4% of the time, respectively. Evaluation of resident transport performance occurred consistently in only 23.3% (neonatal) and 21% (pediatric) of programs. Most programs (90.3%) endorsed the concept of a curriculum that would uniquely provide an integrated experience in critical care transport to increase resident exposure, competence, and confidence. Pediatric residency participation in neonatal and pediatric critical care transport continued to decline among training programs. Residents participating in transports were less likely to function as team leaders and frequently did not receive performance evaluations. Most respondents welcomed a curriculum that would increase residents' exposure to the critically ill infants and children transported by neonatal and pediatric teams.