Pediatric Trainee Needs Assessment for Challenging Interactions

A listing of all general paediatricians in the country was obtained from the directory of members of the Australian College of Paediatrics. Each of the 287 paediatricians identified was sent a questionnaire requesting information about morbidity patterns of patients seen in their practices and their views regarding paediatric training. The response rate was 80.9%. Half the respondents had been in practice for 10 years or less, while two-thirds practised in a capital city. Respondents rated their training in each of 10 organic specialty areas, on average, as having been appropriate. However, when given a listing of nine areas related to child development and behaviour, chronic disease and counselling, 70% rated training in these areas as having been inadequate; this figure was even higher for recent graduates. Less than one-third had formal training in developmental, behavioural and community paediatrics; the remaining two-thirds of respondents acquired their knowledge by clinical experience, books or journals, professional contacts or meetings. This was despite the fact that almost 80% of respondents felt that practical experience was not an adequate substitute for formal training in developmental and behavioural paediatrics. There was an encouraging trend for paediatricians who had been in practice for 10 years or less to have had training in these areas, although the number was still less than half. Almost 90% of respondents felt that changes were needed in paediatric training to equip trainees for general paediatric practice, while 62% of respondents were of the opinion that the present FRACP training system mitigated against appropriate training for general paediatrics.(ABSTRACT TRUNCATED AT 250 WORDS)

Sir .—I write to laud the articles by Hoekelman 1 and Cohen and colleagues 2 in the February 1989 issue of AJDC . In looking at the balance between the financial needs of young people in pediatric training and the financial distress that institutions increasingly are incurring and are going to incur to an even greater degree, one wonders whether, in addition to some of the solutions suggested by the above authors, pediatric residency training should be changed, both at the training program level and at the American board level. Of the total 3 years in pediatric residency at our institution, 3 months are spent on vacation and 6 months are spent in electives. Of these electives, one is psychosocial and of definitive value in future practice. On the other electives, the resident acts as a junior fellow, by and large, doing the initial consultation on the patient for the fellow

Current situation of Specialized Health Training in pediatrics and its specific areas: Challenges and needs

BackgroundAs artificial intelligence (AI) increasingly integrates into medical education, its specific impact on the development of clinical skills among pediatric trainees needs detailed investigation. Pediatric training presents unique challenges which AI tools like ChatGPT may be well-suited to address.ObjectiveThis study evaluates the effectiveness of ChatGPT-assisted instruction versus traditional teaching methods on pediatric trainees’ clinical skills performance.MethodsA cohort of pediatric trainees (n = 77) was randomly assigned to two groups; one underwent ChatGPT-assisted training, while the other received conventional instruction over a period of two weeks. Performance was assessed using theoretical knowledge exams and Mini-Clinical Evaluation Exercises (Mini-CEX), with particular attention to professional conduct, clinical judgment, patient communication, and overall clinical skills. Trainees’ acceptance and satisfaction with the AI-assisted method were evaluated through a structured survey.ResultsBoth groups performed similarly in theoretical exams, indicating no significant difference (p > 0.05). However, the ChatGPT-assisted group showed a statistically significant improvement in Mini-CEX scores (p < 0.05), particularly in patient communication and clinical judgment. The AI-teaching approach received positive feedback from the majority of trainees, highlighting the perceived benefits in interactive learning and skill acquisition.ConclusionChatGPT-assisted instruction did not affect theoretical knowledge acquisition but did enhance practical clinical skills among pediatric trainees. The positive reception of the AI-based method suggests that it has the potential to complement and augment traditional training approaches in pediatric education. These promising results warrant further exploration into the broader applications of AI in medical education scenarios.

AimsHealth Education England (HEE) established the ‘Enhancing Junior Doctors’ Lives’ programme in 2016, aiming to address a range of issues that were having a significant negative impact on the quality...

BackgroundThe transition period of becoming a new paediatric registrar has limited study. Consequently, the learning needs of such trainees are unclear including educational interventions that may improve the process. This qualitative study examined the negative and positive experiences of transitioning paediatric trainees to identify learning needs and subsequently derive educational interventions that are perceived to ease transition.MethodsThis was a qualitative study of semi-structured interviews with Wales deanery paediatric speciality trainees 3 and 4 (ST3 and ST4) undergoing transition to registrar. Participants were asked to recall one positive and one negative experience during transition using the critical incident technique (CIT). Transcribed responses were coded and thematically analysed and categorised into higher and lower order themes.ResultsSix paediatric trainees were interviewed for the study. A total of eighteen codes relating to learning needs were identified and dichotomised into two higher order themes; clinical skills, and leadership and management skills, with further exploration into lower order themes. Clinical skills included child protection procedures, difficult communication with relatives, emergencies, childhood death, difficult procedures, tertiary level neonatal care, managing family anxiety and expectations, dealing with uncertainty and running clinics. Leadership and management skills involved clinical decision making by new registrars, leading ward rounds, managing workload, leading a team and supervising junior colleagues. For educational interventions, sixty-seven initial codes were recorded and combined to form thirty-two lower order themes under six higher order themes. This outlined six educational interventions perceived to ease the transition to the registrar grade including; acting up whilst a senior house officer, seniors providing feedback, seniors providing support, staff providing support, trainee familiarisation with the new registrar placement and trainees maximising SHO learning opportunities.ConclusionsThis study provided a grounding upon which further research can be based, by identifying learning needs within the themes of clinical skills and leadership and management skills, as well as providing further descriptions of perceived beneficial educational interventions that ease transition to paediatric registrar. Furthermore, this study proposes evidence-based recommendations involving five key stakeholders to improve the experience of transition for future trainees. These stakeholders include; trainees, seniors, educators, nursing staff and rota coordinators.

The objective of the study was to identify any differences between emergency physicians and emergency trainees and paediatricians and paediatric trainees in performing paediatric lumbar punctures (LPs). Anonymous cross-sectional electronic survey was distributed to emergency physicians, emergency trainees, paediatricians and paediatric trainees within three hospitals of a single public health network. There were four standardised clinical scenarios (neonate, infant, young child and adolescent), with accompanying questions relating to neurological evaluation and imaging prior to LP, the use of written consent forms and parental presence during the procedure. Paediatricians and paediatric trainees have greater confidence performing LP on neonates and infants, while emergency physicians and emergency trainees are more confident in older children. The only differences in self-reported neurological examination prior to LP was paediatricians and paediatric trainees being more likely to perform fundoscopy than were emergency physicians and emergency trainees in infants (21% vs 8%, P = 0.03) and young children (44% vs 16%, P < 0.001). Less than half of both groups of doctors would obtain written consent for paediatric LPs. Emergency physicians and emergency trainees were much more likely to encourage parents to remain in the room during the procedure than their paediatric counterparts (95% vs 37%, P < 0.0001). Paediatricians and paediatric trainees are more likely to be confident in performing LP in very young children than are emergency physicians and emergency trainees. They are more likely to perform fundoscopy prior to the procedure, but are much less likely to encourage parental presence during the LP.

In Africa, pediatric liver transplantation (PLT) is currently only performed in Egypt and South Africa, leaving those who require treatment in Kenya to travel abroad. The aim of this study was to determine whether sufficient capacity and need exists in Kenya to establish a safe and sustainable PLT program. A descriptive analysis of the intensive care unit (ICU) beds, surgical workforce, current hepatobiliary volume, and estimated prevalence of pediatric liver disease (PLD) was conducted across 17 hospitals in Kenya between July and September 2020. Data were collected from medical superintendents, directors of surgical departments, or nominated proxies at Kenyan Level 5 and 6 hospitals via a web-based survey. A total of 165 ICU beds were reported at 17 facilities, with 15 facilities reporting five or more beds. About 39% of general surgeons at responding hospitals performed hepatobiliary procedures, and 30% performed pediatric surgeries. Only 10% of surgeons had pediatric training. Over half (57%) of hospitals performed hepatobiliary procedures; at the maximum, 1-5 cases were performed per week including cholecystectomy to Kasai portoenterostomy and hepatectomy. Across 13 hospitals, there were an estimated 192-570 cases of PLD seen per month. The most common PLDs were hepatitis B, neonatal hepatitis, cirrhosis, and acute hepatic failure. Overall, two hospitals possessed the minimum workforce and resources to attempt PLT. In Kenya, ICU bed availability, pediatric surgical training, and hepatobiliary volume are limited. However, the high prevalence of PLD demonstrated a significant need for PLT across all Kenyan hospitals.

ObjectivesSimulation-based training is extensively utilised in medical education within high-income countries, but its implementation in low and middle-income countries (LMICs) has been restricted. Sudan’s healthcare system, especially in acute and...

Emergency medical services have been organized to meet the needs of adult patients. A study was undertaken to determine the training in pediatrics offered to paramedics and emergency medical technicians throughout the United States and the equipment carried by prehospital care provider agencies. Most training (50%) takes place at colleges and universities and the remainder at hospitals and emergency medical services agencies. Many programs (40%) have less than ten hours of didactic training in pediatrics and 41% offer ten hours or less of clinical experience. Some programs offer no training in pediatric emergency medicine. The most common deficiencies in pediatric equipment included back-boards, pediatric drugs, resuscitation masks, and small intravenous catheters. More attention to training and equipping prehospital personnel for pediatric emergencies may help to improve outcomes of out-of-hospital resuscitations of infants and children.

Training in Paediatrics Edited by Mark Gardiner, Sarah Eisen, Catherine Murphy. . Published by OUP, Oxford, 2009, pp 496, £49.95 (paperback). ISBN: 978-0-19-922773-0 ![Graphic][1]</img> I was thrilled to commence my...

This programme was designed by members of the London School of Paediatrics Trainee Committee, supported by the Curriculum Delivery TPD. The programme had 20 Paediatric trainees for its first year...

Background and objectives: The COVID-19 pandemic has put strain on the activities and well-being of health care workers. We aimed to measure the direct and indirect impact on a personal and professional level for paediatric trainees in Flanders, Belgium.Study design: Junior representatives of the Flemish Society for Paediatrics (Jong VVK) conducted a longitudinal study among their fellow paediatric trainees. The impact of COVID-19 on daily tasks, education and emotional well-being for the first (March-April 2020) and second wave (October-November 2020) of the pandemic were studied.Results: One hundred and nineteen surveys were completed in the first wave, representing data of 51% (119/233) of the total number of paediatric trainees in Flanders. Eighty surveys were completed in the second wave. Educational program changes occurred in 25% (30/119) of trainees and more than half (61%; 72/119) described the pandemic as an impediment for their educational progress. The perception of impaired education persisted for 30% of the responders (24/80) during the second wave. One out of three (30%; 35/119) felt their job was more exhausting than usual and 38% (45/119) perceived more stress at work. These numbers were comparable at both time points. Increases in stress paralleled with increased irritability in daily life and poorer sleep quality. Conclusions: COVID-19 had an important impact on the daily tasks, education and emotional well-being of the paediatric trainees. Medical training centres should be aware that there is a perception of impediment on the educational program of the paediatric trainee.

27. EFFECTIVENESS OF DELIVERING DIFFICULT NEWS TRAINING: IMPROVED SKILLS AND SELF-EFFICACY OF PEDIATRIC TRAINEES

AimsWe surveyed Paediatric trainees in the East of England Deanery to identify the rates of breastfeeding within Paediatricians; the age at which trainees continue to breastfeed until, and to identify...