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Excerpt
OBJECTIVE: Residents rotating in pediatric emergency department (ED) are expected to familiarize themselves with the management of acute pediatric ailments. However, it remains to be demonstrated if rotation in a busy ED without targeted teaching substantially adds to their existing knowledge base. To evaluate the impact of pediatric ED rotation on the knowledge base of residents from different specialties, we examined management of fever without source.
METHODS: Questionnaires based on case scenarios of febrile children in different age groups varying from 0–36 months were administered to residents rotating through a pediatric ED at the beginning and end of a month long rotation. The residents were scored based on their correct responses (as suggested by published guidelines). During ED rotation residents received routine clinical assignments.
RESULTS: Seventy-one (n=71) residents (Pediatrics 20, Emergency Medicine 27, Family Practice 17, other 7) rotated through the ED over a period of eight months for which data was collected. Mean scores (SE) on the questionnaire-based tests at the start and end of the rotation was not different [4.72 (.19) vs. 5.06 (.21); p = 0.17.] Overall, pediatric residents performed better than non-pediatric residents, but when adjusted for level of training and training specialty by one-way ANOVA, there was no difference between groups.
CONCLUSION: During pediatric ED rotation, routine clinical assignments may not always improve residents’ knowledge of managing common pediatric ailments. More targeted teaching is required.
