Pediatric residents face unique challenges when learning to perform pediatric procedures due to anatomical, physiological, and behavioral differences. Procedural skills are an essential skill as new medical school graduates enter the patient care setting. Traditionally, this training has involved the “see one, do one, teach one” model. However, with the increasing focus on patient safety this is no longer acceptable.
The Accreditation Council for Graduate Medical Education (ACGME) requires pediatric residencies to provide sufficient training in 14 procedures (Table 1) and that residents should be monitored by the residency program for appropriate skill development. In a 2007 report, Gaies et al1 found that fewer than 65% of pediatrics program directors reported that all or almost all of their residents were competent to perform the following ACGME required procedures at the completion of training: intravenous (IV) placement (48%), arterial puncture (51%), umbilical arterial catheter placement (55%), umbilical venous catheter placement (57%), intubation (60%), and venipuncture (61%). In another study, Leone et al2 reported that the median success rates of neonatal intubations were 33% for pediatric level (PL)1 residents and 40% for PL2 and PL3 residents. Many residency programs are now looking to develop innovative and adequate opportunities to improve procedural skill competency.
Simulation Based Medical Education has been shown to provide opportunities to practice procedural skills and make errors without
harming patients in a safe and controlled environment.3 It is specifically designed to be learner-centered rather than patient- centered. With live patients, learning time is often limited, and access is dependent on pers...
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... improvement in care. Furthermore, the “usefulness” was measured one month and one year after the workshop, and it is not known how this compares to the immediate views and whether the information from skills lab was actually retained or retaught.
Overall, we believe that Simulation Procedural Skills Training was seen to be an effective method of teaching pediatric procedures as perceived by the Residents. The results of the survey and feedback show that time and focus can be redirected for PGY-1 residents to focus on the more likely performed skills in order to improve clinical performance and confidence. Future studies may evaluate retention rates and clinical success rates as the relate to an improvement in patient care and the development of a curriculum to provide upper level residents with more procedural skills training and practice to develop competency.
The first question I expect to be asked by every interviewer is "why anesthesiology now?" In 2012, after 6 years of post-graduate training, I was thrilled and elated to finally became a board-certified pediatric hematologist/oncologist. Three years later, I am ready to go back to residency. Pediatric hematology/oncology was one of my earliest rotations as a third year medical student and I fell in love with the pathology and, of course, the kids. After that rotation, I, perhaps naively, didn 't give much thought to other specialties and focused solely on pediatrics, going on to complete my pediatrics residency at the University of Michigan, followed by fellowship at the University of Colorado. Now, three years after my transition into post-training practice, I have come to realize the realities of pediatric specialized medicine are not what I expected when I chose this career.
Hinkle, J., Cheever, K., & , (2012). Textbook of medical-surgical nursing. (13 ed., pp. 586-588). Philadelphia: Wolters Kluwer Health
Davenport, Joan M., Stacy Estridge, and Dolores M. Zygmont. Medical-surgical nursing. 2nd ed. Upper Saddle River, N.J.: Pearson Prentice Hall, 2008, 66-88.
... simulations, which range from computer run screen simulations to physical simulations, are helping the medical trainees acquire high edge experiences from repetitive exercises of complex medical procedures. The skills and understanding derived from this kind of training is hopefully expected to improve the actual medical service delivery once the students graduate.
Because of his leadership abilities, he is often sought out to evaluate program and service activities. For example, he utilized this recognized body of evidence to form and lead a team that evaluated and developed a standardized preference cards, an effective orthopedics and urology instrumentation handlings, an effective communication intra-and-interdepartmentally, and perioperative nursing competency process for this program. He was able to funnel creative recommendations from his team into practical applications beyond the application of this process on the perioperative, SPS and surgical units. Through a review of CMS, Joint Commission, and AORN standards, he identified a comprehensive ortho and neuro-competency, and urology competency process for the surgical interdisciplinary staff. During the process, he ensures that every member of the team identify goals and measurable outcomes; quickly and accurately calibrates project priorities; cultivates a culture of openness while building consensus among the group; and actively collaborating multidisciplinary team actions toward a common goal. The implementation of the process lead to decreased cancellation of cases due to compromised instrumentation, failed timely processing of limited positioners and inadequate/incomplete unit preparation of the complex surgical cases. This has also resulted to increased
Aside from the firm decision, being familiar of the concept in paediatrics and its set-up must also be considered. Previous exposures to paediatric wards as well as acute care units can sharpen the skills of a nurse practitioner. Most part of the work involves taking into consideration the growth and development of children and how the nurse should manage to intervene when alterations occur such as hospitalization, procedures and operations to the child. This external factor does not only influence the child...
Hinkle, Janice L, Cheever, Kerry H. (2014). Brunner &Suddarth’s textbook of Medical-Surgical Nursing. Philadelphia: Wolters Kuwer/Lippincott Williams &Wilkins.
On the other hand, I learned new concepts and terms. Simulation repeats some essential aspects of patient situation so that the situation may be understood and managed when it occurs in real clinical practice. Students in the school of nursing use the simulation learning center to learn and get experience in the field. The simulation is an educational process that requires the learner to demonstrate procedural techniques, decision making, and critical thinking. I learned that a simulation experience allows students to critically analyze their own actions and reflect on their own skill set. As a nursing student, I learned you have to complete clinical hours and practice in the simulation learning center. To become a certified nurse there are many training courses, exams to pass, and in the field experience to complete. Health professionals such as a nurse,
A career in nursing is extremely important in today's society. Without nurses to assist doctors in the care of patients, the quality of patient care may not be the same. Nurses do not just serve a great role in our community, but they also are just as needed as a police officer patrolling the streets or a teacher in the classroom. Although it may seem very easy to become a nurse, one's desire must be very strong in order to to actually pursue a career in nursing. Pediatric nursing is not just a profession that one would desire, but is a profession that is widely needed.
H. Al-Elq, (2010),Simulation-based medical teaching and learning Simulation-based medical teaching and learning Family Community Med.
Smeltzer, S. C., Bare, B. G., Hinkle, J. L., & Cheever, K. H. (2010). Brunner & Suddarth’s textbook of medical-surgical nursing (12th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
The compulsion by our university and the respective facilities during my clinical placements to always be updated in clinical skills and practices played a major role in keeping me well informed and self-assured to perform my duties well. However, one of the main setbacks in maintaining practices is the subtle differences in protocols in different facilities while on clinical placements. This differences in protocols sometimes made it difficult for us to adapt with the change as we would have already been familiarised ourselves with different practices whilst in other
This essay is going to reflect upon the nursing skills I developed during a period of placement simulations, placing emphasis on oral care, communication with a non-engaging patient and bed bath. It will outline the fundamental aspects of clinical nursing skills that I have begun to acquire. This will also highlight the learning processes which took place and how it helped me to enhance my knowledge, and ethical values in order to deliver quality and safety of care. Using a variety of sources from current literature, I will use a reflective model to discuss how I have achieved the necessary level of learning outcome. By utilising this model I hope to demonstrate my knowledge and understanding in relation to these skills as well as identifying areas with scope for learning.
Over this 48-year history, demographic trends in medicine and in pediatrics result in a workplace that now made up of nearly equal numbers of men and women, with females having the majority of pediatric residents and neonatology students entering training. American medical schools contributed the large majority of students in NPM at its inception, but by the mid-1990s, international graduates became about one- half of the trainees. Although this number dropped somewhat in the early 2000s, International graduates continue to be an important fraction of the workforce in NPM. Most International graduates are eligible to remain in the United States for practice and many are eligible for certification by the American Board in general pediatrics, a requirement for board-eligibility in NPM.
Safety is vital in the clinical and academic field. Continuous training through fire drills, in-service training on Campus Violence and Emergency protocols are done every year. It is also important to be aware of the policies and procedures of the campus to ensure that you are following the correct way to do things. The most important thing to do is to anticipate ways that could pose a safety risk to students or patients. The simple act of diffusing some tension and petty quarrels can prevent more serious problems later on.