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Pediatric Case Exposure During Emergency Medicine Residency
Author(s) -
Li Joyce,
Roosevelt Genie,
McCabe Kerry,
Preotle Jane,
Pereira Faria,
Takayesu James K.,
Monuteaux Michael,
Bachur Richard G.
Publication year - 2018
Publication title -
aem education and training
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 9
ISSN - 2472-5390
DOI - 10.1002/aet2.10130
Subject(s) - medicine , pediatric emergency medicine , interquartile range , medical diagnosis , residency training , emergency medicine , pediatrics , family medicine , emergency department , emergency physician , continuing education , pathology , medical education , psychiatry
Abstract Objective While emergency medicine ( EM ) physicians treat the majority of pediatric EM ( PEM ) patients in the United States, little is known about their PEM experience during training. The primary objective was to characterize the pediatric case exposure and compare to established EM residency training curricula among EM residents across five U.S. residency programs. Methods We performed a multicenter medical record review of all pediatric patients (aged < 18 years) seen by the 2015 graduating resident physicians at five U.S. EM training programs. Resident‐level counts of pediatric patients were measured and specific counts were classified by the 2016 Model of Clinical Practice of Emergency Medicine ( MCP ) and Pediatric Emergency Care Applied Research Network ( PECARN ) diagnostic categories. We assessed variability between residents and between programs. Results A total of 36,845 children were managed by 68 residents across all programs. The median age was 6 years. The median number of patients per resident was 660 with an interquartile range of 336. The most common PECARN diagnostic categories were trauma, gastrointestinal, and respiratory disease. Thirty‐two core MCP diagnoses (43% of MCP list) were not seen by at least 50% of the residents. We found statistically significant variability between programs in both PECARN diagnostic categories (p < 0.01) and MCP diagnoses (p < 0.01). Conclusion There is considerable variation in the number of pediatric patients and the diagnostic case volume seen by EM residents. The relationship between this case variability and competence upon graduation is unknown; further investigation is warranted to better inform program‐specific curricula and to guide training requirements in EM .