The teaching of pediatric emergency procedures to medical students - a pilot study

Abstract

Background and Goal of Study: Junior doctors are of ten first on scene in the emergency department. It is therefore crucial that they are capable of performing life-saving procedures. In general, pediatricians or anesthesiologists handle pediatric emergencies. However, depending on hospital location, local structure and resources junior doctors can be compelled to perform these life-saving procedures. Many junior doctors will not learn additional pediatric skills after the end of the assigned curriculum in medical school, even though they can be expected to handle acutely ill children. We designed a four-hour workshop-based course to introduce Danish medical students to clinical skills, needed to manage pediatric emergencies. Materials and methods: 12 medical students all in their fourth-six th year of medical school participated in a four-hour course in pediatric procedures. Students were divided into groups of four. The course included three workshops with theory and practical training in: 1. Intraosseous access practiced on a phantom and foreign body airway obstruction practiced with two real size manikins 2. Neonatal resuscitation 3. Umbilical vein catheterization Prior to the workshops the students were presented with a multiple-choice questionnaire (MCQ). The MCQ was repeated at the end of the course. At the end of the training sessions an OSCE was performed and the students were assessed using a standardized checklist. Data from the MCQ pre and post test were analyzed using the Wilcoxon Signed Rank test and a p-value < 0,01 was considered significant. Results and discussion: A total of 12 medical students performed the pre and post MCQ test and the four practical tests. Table 1 shows the percentage of correct answers for the pre and post MCQ. (Table presented) A Wilcoxon signed-rank test shows a significant improvement in the post-test (W= 78 Z = 3,04, p< 0.005). The OSCE scores can be seen in table 2. (Table presented) The gaps seen in the OSCE may be due to specific points not being emphasized enough during the training sessions, or the fact that students' theoretical knowledge is difficult to apply in more complex clinical situations. Conclusion: This small pilot study indicates that students can learn to perform pediatric emergency procedures, in an educational environment. The students performed well in the MCQ but OSCE identified gaps. Future research in students' ability to translate theoretical knowledge into practical skills is necessary.