Pediatric Emergency Medicine Fellowship Programs Research Articles

Pediatric Emergency Medicine Fellowship Programs

Pediatric Emergency Medicine Fellowship Programs

Bedside Ultrasound in Pediatric Emergency Medicine Fellowship Programs in the United States

Bedside ultrasound (BUS) can provide critical information in a rapid and noninvasive manner to the emergency physician. It is widely used in emergency departments (ED) throughout the nation. Literature shows that BUS shortens patient stay and increases patient satisfaction. General emergency medicine (EM) residencies incorporate BUS training in their curricula. However, there are limited data about the training that pediatric emergency medicine (PEM) fellows receive. To determine the extent of training and use of BUS in PEM fellowship programs. A 29-question survey was mailed to all (57) PEM fellowship program directors in the spring of 2006. The response rate was 81% (46/57). Fifty-seven percent (26/46) of the responding PEM fellowship program directors reported that their faculty used BUS in their departments. At 50% (23/46) of programs, fellows perform BUS studies. Sixty-five percent (30/46) of PEM fellowships reported that their fellows receive some BUS training, but only 15 of these programs included BUS training in the curriculum as a 2- to 4-week ultrasound rotation.Sixty-five percent (30/46) of PEM fellowship programs had access to an ultrasound machine, but only 28% (13/46) of programs had their own machine. The main reason not to own an ultrasound machine was a lack of ultrasound expertise in their department (67%, 22/33). Bedside ultrasound training was provided by general EM physicians in 57% (17/30) of programs. Eighty-seven percent of the directors agree that BUS training would benefit their practice.The 2 factors significantly associated with the likelihood of having formal BUS training were access to an ultrasound machine (87% vs 55% P=0.04) and presence of an adult ED with an EM residency at the program (80% vs 42% P=0.03). Pediatric emergency medicine fellowship programs at children's hospitals were significantly less likely to have formal training (33.3% vs 74.2%; P=0.01). Despite literature supporting the benefits of BUS in the ED, many PEM fellowship programs do not incorporate BUS training for their PEM fellows. Most PEM fellows who receive training in BUS are instructed by physicians trained in EM, not PEM.

Pediatric Emergency Medicine Fellowship Programs

Pediatric Emergency Medicine Fellowship Programs

Current Utilization of Continuous End-Tidal Carbon Dioxide Monitoring in Pediatric Emergency Departments

End-tidal carbon dioxide (ETCO2) monitoring has numerous clinical applications in the emergency setting. This study was designed to explore the current availability and utilization patterns for continuous ETCO2 monitoring in pediatric emergency departments. A Web-based survey was distributed to directors of all accredited pediatric emergency medicine fellowship programs in the United States and Canada. Eighty-one percent of directors completed this survey. Eighty-eight percent had access to ETCO2 monitoring for intubated patients and 53% for nonintubated patients. Seventy-nine percent of respondents used ETCO2 monitoring "always" or "often" for endotracheal tube confirmation. Only 20% of respondents used ETCO2 monitoring "always" or "often" for moderate sedation, 16% for trauma, and 6% for acid-base disturbances. One hundred percent of respondents who used ETCO2 monitoring felt that it was easy to use. The most common reason for not using ETCO2 monitoring was lack of equipment (65%). ETCO2 monitoring is widely available, yet underutilized, for spontaneously breathing patients in pediatric emergency departments.

Pediatric Emergency Medicine Fellowship Programs

Pediatric Emergency Medicine Fellowship Programs

Need for Standardized Sign‐out in the Emergency Department: A Survey of Emergency Medicine Residency and Pediatric Emergency Medicine Fellowship Program Directors

To determine the existing patterns of sign-out processes prevalent in emergency departments (EDs) nationwide. In addition, to assess whether training programs provide specific guidance to their trainees regarding sign-outs and attitudes of emergency medicine (EM) residency and pediatric EM fellowship program directors toward the need for the development of standardized guidelines relating to sign-outs. A Web-based survey of training program directors of each Accreditation Council for Graduate Medical Education (ACGME)-accredited EM residency and pediatric EM fellowship program was conducted in March 2006. Overall, 185 (61.1%) program directors responded to the survey. One hundred thirty-six (73.5%) program directors reported that sign-outs at change of shift occurred in a common area within the ED, and 79 (42.7%) respondents indicated combined sign-outs in the presence of both attending and resident physicians. A majority of the programs, 119 (89.5%), stated that there was no uniform written policy regarding patient sign-out in their ED. Half (50.3%) of all those surveyed reported that physicians sign out patient details "verbally only," and 79 (42.9%) noted that transfer of attending responsibility was "rarely documented." Only 34 (25.6%) programs affirmed that they had formal didactic sessions focused on sign-outs. A majority (71.6%) of program directors surveyed agreed that specific practice parameters regarding transfer of care in the ED would improve patient care; 80 (72.3%) agreed that a standardized sign-out system in the ED would improve communication and reduce medical error. There is wide variation in the sign-out processes followed by different EDs. A majority of those surveyed expressed the need for standardized sign-out systems.

Need for Standardized Sign-out in the Emergency Department: A Survey of Emergency Medicine Residency and Pediatric Emergency Medicine Fellowship Program Directors

Need for Standardized Sign-out in the Emergency Department: A Survey of Emergency Medicine Residency and Pediatric Emergency Medicine Fellowship Program Directors

Pediatric Emergency Medicine Fellowship Programs

Pediatric Emergency Medicine Fellowship Programs

Pediatric Emergency Medicine Fellowship Programs

Pediatric Emergency Medicine Fellowship Programs

The University of Chicago Pediatric Emergency Medicine Fellowship Program

Director, Pediatric Emergency, Medicine Fellowship Program, Chief, Section of Pediatric Emergency Medicine, Assistant Professor of Pediatrics The University of Chicago, Pritzker School of Medicine, 5841 S. Maryland Avenue, MC 0810 Chicago,IL [email protected]

Pediatric Emergency Medicine Fellowship Programs

A special thank you to all the PEM Fellowship Directors for their continued support of this fellowship program listing and Regina Williams for her secretarial support in making this survey possible.

The Educational Experience of Pediatric Emergency Medicine Fellows in the Use and Application of Procedural Sedation/Analgesia

The purpose of this study is to describe the clinical and educational experience provided to the pediatric emergency medicine (PEM) fellows in procedural sedation/analgesia during their course of training. A nonanonymous survey was completed by the program director of each Accreditation Council for Graduate Medical Education (ACGME)-accredited PEM fellowship program listed in the 2001 to 2002 Graduate Medical Education Directory. Information relating to program demographics, agents available for use in the emergency department (ED), and the educational opportunities offered to trainees was sought. Each of the 32 ACGME-accredited programs completed the survey. Thirty programs report using procedural sedation and analgesia (PSA) to facilitate the completion of nonpainful and 32 programs to facilitate the completion of painful procedures in the ED. Twenty-nine programs (92%) permit their fellows to provide PSA independently after meeting credentialing criteria at their institution. Formal didactic sessions, direct supervision of procedures, and dedicated journal clubs were the 3 most frequently cited educational methods reported. The educational method chosen was not predicted by the ED type, the size of the training program, or by the volume of patients evaluated in the ED. Twelve program directors report their belief that a minimum number of procedures should be completed prior to completion of the training program. There is wide variation in the educational methods used by PEM fellowship training programs in procedural sedation/analgesia.

Pediatric Emergency Medicine Fellowship Programs

A special thank you to all of the Pediatric Emergency Medicine Fellowship Directors for their continued support of this fellowship program listing and to Regina Williams for her secretarial support in making this survey possible.

Pediatric emergency medicine fellowship training in the new millennium.

OBJECTIVE Fellowship training in pediatric emergency medicine has been available since the early 1980s. Its availability increased rapidly in the late 1980s and early 1990s, but its growth has been much slower in recent years. In this report, we characterize and compare the training programs of today to those that existed 10 years ago. Our study deals with program content and design, focusing on five aspects of fellowship training: demographics, curriculum, clinical emergency department time, research, and benefits. The data gathered in this study are meant to assist programs, both new and old, in enhancing their fellowship training.METHODS A 43-question survey was mailed to all known pediatric emergency medicine fellowship program directors in March of 2000. Two additional attempts were made to obtain survey responses. Forty of the 50 program directors responded, for a response rate of 80%. Statistical analysis was performed, and the data were compared with data that were gathered in two previous studies of fellowship training programs conducted in 1988 and 1991.RESULTS Fellowship training in pediatric emergency medicine continues to grow but at a slower pace than previously experienced. The number of training programs has increased by 27% over the past 10 years; however, the number of first-year positions has only increased by 15%. Clinical fellow supervision has increased significantly over the years, likely as a result of changes in reimbursement. In 1990, 75% of fellows worked unsupervised in the emergency department versus 23% of first-year fellows, 56% of second-year fellows, and 74% of third-year fellows in the year 2000. The structure of the fellowship curriculum has become more standardized during the past 10 years, with numerous core rotations required by most programs. The percentage of programs offering protected research time has changed significantly over the years, with the amount of time increasing from 40% in 1988, to 95% in 1990, to 100% in 2000. The amount of clinical time has also increased with the transition to a 3-year program.CONCLUSIONS Pediatric emergency medicine continues to expand as a pediatric subspecialty but at a slower rate. During the previous decade, fellowship training has become more structured, with greater emphasis being placed on fellow supervision, standardization of education, and research. These data are meant to assist new as well as established fellowship programs with the development of their training curriculum.

Pediatric Emergency Medicine Fellowship Programs

Pediatric Emergency Medicine Fellowship Programs

Oral versus intravenous: Rehydration preferences of pediatric emergency medicine fellowship directors

The American Academy of Pediatrics (AAP) recommends oral rehydration therapy (ORT) for management of uncomplicated childhood gastroenteritis with mild-moderate dehydration. However, ORT is widely underused relative to their recommendations. We compared ORT use by directors of Pediatric Emergency Medicine (PEM) fellowship training programs with AAP recommendations, and sought to identify their barriers to ORT. Mail/fax survey of the directors of U.S. and Canadian PEM fellowship programs. The survey included 10 scenarios of mild or moderately dehydrated children with gastroenteritis, a personal innovativeness scale, self-assessment of ORT experience and knowledge, and open-ended questions regarding perceived barriers to ORT use. 60/67 (89.6%) PEM fellowship program directors responded. All reported experience with and knowledge about ORT. Only 10/58 (17.2%) believe ORT is usually better than intravenous (i.v.) rehydration in all 10 clinical scenarios, and only 4/58 (6.7%) usually use ORT in all 10 scenarios. 18/58 (31%) usually use ORT for all mildly but no moderately dehydrated children. ORT use did not correlate with personal innovativeness scores. Important barriers cited by respondents include additional time requirements for ORT relative to i.v. rehydration (76.7%) and expectation of i.v. rehydration by parents (41.7%) or primary care physicians (10%). Relative to AAP recommendations, PEM fellowship directors underuse ORT, especially for moderately dehydrated children. Physician innovativeness does not influence ORT use. Further study of effectiveness, length of stay, staff requirements, and ORT acceptance in the emergency department setting, especially in children with moderate dehydration, may influence ORT use.

Pediatric Emergency Medicine Fellowship Programs.

Pediatric Emergency Medicine Fellowship Programs.

Pediatric emergency medicine fellowship programs.

Pediatric emergency medicine fellowship programs.

Pediatric emergency medicine fellowship programs.

Pediatric emergency medicine fellowship programs.

Obtaining a faculty position in academic emergency medicine.

The purpose of this article is to help explore the general aspects of finding an attending position in academic emergency medicine. Previous studies have examined the academic expectations of individuals in both emergency medicine residencies 1,2 and pediatric emergency medicine fellowship programs. 3,4 . The present goal is to look beyond postgraduate training in pediatric emergency medicine and to present a general framework for acquiring an attending position. This will also serve as an aid in finding a job that will launch one's academic career in pediatric emergency medicine. The followings areas will be addressed: 1) networking, 2) preparing a curriculum vitae, and 3) questions to consider during the interview process.