Experimental Biology 2010: Pediatric Resident Knowledge And Comfort Level With Resuscitation Following An Educational Intervention

Purpose of Study: To determine if rising second year residents’ comfort and knowledge levels with resuscitation protocols and procedures are improved following an educational intervention.

Methods Used: Rising second year general pediatric residents at an urban pediatric teaching hospital were exposed to an eight hour educational session consisting of didactic lectures, skills stations and mock codes using high fidelity simulation. Residents were asked to complete a survey before and after the intervention describing their experience and comfort level with performing or teaching resuscitations and procedures, as well as answer content based questions to assess their knowledge of resuscitative interventions.

Summary of Results: Of 24 residents surveyed, 2 had led a code, 5 had obtained central venous access, 1 had inserted an intraosseous (IO) needle, and 6 had performed endotracheal intubation. For questions surrounding comfort with procedures, including calling and leading a code, obtaining intravenous (IV) or IO access, and airway management, 16 of 18 questions showed a significant change (p<0.05) in mean score from pre to post survey responses. The mean increase in comfort level for performing procedures ranged from 0.2-1.8 on a 5 point Likert scale and the mean increase in comfort level for teaching a procedure ranged from 0.2-2. The questions with the greatest mean difference concerned teaching peripheral IV and IO needle insertion (p<0.001). The mean difference between pre- and post- intervention content based question scores was 23.9% [95% CI 14-34] (p<0.001).

Conclusions: During their first year of training, pediatric residents had little experience and felt uncomfortable with resuscitative interventions. An educational review improved their knowledge and comfort level with these skills. As they graduate to become senior residents, a hands-on review of procedures and practice using mock code simulations provides residents with not only the knowledge and skills to provide better care to patients, but also instills the confidence needed to teach these skills to others.