Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    In: Pediatric Anesthesia, Wiley, Vol. 29, No. 7 ( 2019-07), p. 753-759
    Abstract: Resident education in pediatric anesthesiology is challenging. Traditional curricula for anesthesiology residency programs have included a combination of didactic lectures and mentored clinical service, which can be variable. Limited pediatric medical knowledge, technical inexperience, and heightened resident anxiety further challenge patient care. We developed a pediatric anesthesia simulation‐based curriculum to address crises related to hypoxemia and dysrhythmia management in the operating room as an adjunct to traditional didactic and clinical experiences. Aims The primary objective of this trial was to evaluate the impact of a simulation curriculum designed for anesthesiology residents on their performance during the management of crises in the pediatric operating room. A secondary objective was to compare the retention of learned knowledge by assessment at the eight‐week time point during the rotation. Methods In this prospective, observational trial 30 residents were randomized to receive simulation‐based education on four perioperative crises (Laryngospasm, Bronchospasm, Supraventricular Tachycardia (SVT), and Bradycardia) during the first week (Group A) or fifth week (Group B) of an eight‐week rotation. Assessment sessions that included two scenarios (Laryngospasm, SVT) were performed in the first week, fifth week, and the eighth week of their rotation for all residents. The residents were assessed in real time and by video review using a 7‐point checklist generated by a modified Delphi technique of senior pediatric anesthesiology faculty. Results Residents in Group A showed improvement between the first week and fifth week assessment as well as between first week and eighth week assessments without decrement between the fifth week and eighth week assessments for both the laryngospasm and SVT scenarios. Residents in Group B showed improvement between the first week and eighth week assessments for both scenarios and between the fifth week and eighth week assessment for the SVT scenario. Conclusion This adjunctive simulation‐based curriculum enhanced the learner's management of laryngospasm and SVT management and is a reasonable addition to didactic and clinical curricula for anesthesiology residents.
    Type of Medium: Online Resource
    ISSN: 1155-5645 , 1460-9592
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2019
    detail.hit.zdb_id: 2008564-3
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 2
    In: Pediatric Anesthesia, Wiley, Vol. 31, No. 2 ( 2021-02), p. 116-122
    Abstract: Scientific presentations, usually given with slide presentation software such as PowerPoint™, are the most common method for disseminating knowledge to students and peers. Unfortunately, many are boring, text‐heavy, and bullet point–riddled data dumps, with animations or cartoons that obscure or distract rather than clarify the message. These presentations, which we have all sat through and/or delivered, are often so dull that they are referred to as “death by PowerPoint™.” In this paper, the authors intend to impart basic techniques for organizing and communicating information in the most effective, engaging, and actionable ways possible. We focus on three processes: generating ideas and outlining a talk, creating visually appealing uncluttered slides, and delivering an inspiring, practice‐changing presentation. We also discuss considerations for a virtual presentation. We believe that even experienced speakers could benefit from reflecting on these recommendations and editing their slide presentations for clarity and simplicity.
    Type of Medium: Online Resource
    ISSN: 1155-5645 , 1460-9592
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2008564-3
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 3
    In: Pediatric Anesthesia, Wiley, Vol. 26, No. 5 ( 2016-05), p. 481-487
    Abstract: Pediatric anesthesiologists must manage crises in neonates and children with timely responses and limited margin for error. Teaching the range of relevant skills during a 12‐month fellowship is challenging. An experiential simulation‐based curriculum can augment acquisition of knowledge and skills. Objectives To develop a simulation‐based boot camp ( BC ) for novice pediatric anesthesiology fellows and assess learner perceptions of BC activities. We hypothesize that BC is feasible, not too basic, and well received by fellows. Methods Skills stations, team‐based in situ simulations, and group discussions of complex cases were designed. Stations were evaluated by anonymous survey; fellows rated usefulness in improving knowledge, self‐confidence, technical skill, and clinical performance using a Likert scale (1 strongly disagree to 5 strongly agree). They were also asked if stations were too basic or too short. Median and interquartile range ( IQR ) data were calculated and noted as median ( IQR ). Results Fellows reported the difficult airway station and simulated scenarios improved knowledge, self‐confidence, technical skill, and clinical performance. They disagreed that stations were too basic or too short with exception of the difficult airway session, which was too short [4 (4‐3)]. Fellows believed the central line station improved knowledge [4 (4‐3)] , technical skills [4 (4‐4)], self‐confidence [4 (4‐3)] , and clinical performance [4 (4‐3)]; scores trended toward neutral likely because the station was perceived as too basic [3.5 (4‐3)] . An interactive session on epinephrine and intraosseous lines was valued. Complicated case discussion was of educational value [4 (5‐4)], the varied opinions of faculty were helpful [4 (5‐4)] , and the session was neither too basic [2 (2‐2)] nor too short [2 (2‐2)] . Conclusion A simulation‐based BC for pediatric anesthesiology fellows was feasible, perceived to improve confidence, knowledge, technical skills, and clinical performance, and was not too basic.
    Type of Medium: Online Resource
    ISSN: 1155-5645 , 1460-9592
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2016
    detail.hit.zdb_id: 2008564-3
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 4
    In: Pediatric Critical Care Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 17, No. 7 ( 2016-07), p. e309-e316
    Abstract: Tracheal intubation is a core technical skill for pediatric critical care medicine fellows. Limited data exist to describe current pediatric critical care medicine fellow tracheal intubation skill acquisition through the training. We hypothesized that both overall and first-attempt tracheal intubation success rates by pediatric critical care medicine fellows improve over the course of training. Design: Retrospective cohort study at a single large academic children’s hospital. Materials and Methods: The National Emergency Airway Registry for Children database and local QI database were merged for all tracheal intubations outside the Operating Suite by pediatric critical care medicine fellows from July 2011 to January 2015. Primary outcomes were tracheal intubation overall success (regardless of number of attempts) and first attempt success. Patient-level covariates were adjusted in multivariate analysis. Learning curves for each fellow were constructed by cumulative sum analysis. Results: A total of 730 tracheal intubation courses performed by 33 fellows were included in the analysis. The unadjusted overall and first attempt success rates were 87% and 80% during the first 3 months of fellowship, respectively, and 95% and 73%, respectively, during the past 3 months of fellowship. Overall success, but not first attempt success, improved during fellowship training (odds ratio for each 3 months, 1.08; 95% CI, 1.01–1.17; p = 0.037) after adjusting for patient-level covariates. Large variance in fellow’s tracheal intubation proficiency outside the operating suite was demonstrated with a median number of tracheal intubation equal to 26 (range, 19–54) to achieve a 90% overall success rate. All fellows who completed 3 years of training during the study period achieved an acceptable 90% overall tracheal intubation success rate. Conclusions: Tracheal intubation overall success improved significantly during the course of fellowship; however, the tracheal intubation first attempt success rates did not. Large variance existed in individual tracheal intubation performance over time. Further investigations on a larger scale across different training programs are necessary to clarify intensity and duration of the training to achieve tracheal intubation procedural competency.
    Type of Medium: Online Resource
    ISSN: 1529-7535
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 2070997-3
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 5
    In: Pediatric Anesthesia, Wiley, Vol. 31, No. 9 ( 2021-09), p. 968-976
    Abstract: The COVID‐19 pandemic created a situation with an urgent need to produce a virtual system for the 2019–2020 pediatric anesthesiology fellowship cycle. With fellowship interviews beginning in April 2020, there was minimal time to adapt. Each program rapidly developed its own platform, expectations, materials, and process for interviews, and applicants were exposed to a wide array of variability in the process—all while under the stress of interviewing for fellowship positions. Aims The aim of this survey‐based study was to obtain input from applicants to help guide program decisions about “best practice” for the future for both pediatric anesthesiology and other graduate medical education matches. Methods A 28‐question survey was developed utilizing Qualtrics. An anonymous link was sent to all pediatric anesthesiology program directors for distribution of the survey link to all recently matched applicants. Incoming fellows who were accepted outside of the match process were also invited to respond. Results Fifty respondents completed the survey, for a response rate of 30% based on the 167 matched fellowship positions nationwide (50/167). A majority of the respondents reported they felt virtual interviews allowed them to learn the following things equally as well compared with a traditional interview about fellowship programs: salary and benefits, available academic opportunities, available clinical opportunities, clinical schedule of the fellowship, mentorship opportunities, clinical experience and training of the fellowship, and expected work‐life balance during fellowship. Respondents report that the most important factors in making their rank list were perceived goodness of fit, desired geographic location, and perception of program leadership. Additionally, respondents ranked the types of information and interactions that they found most helpful to make decisions. All respondents reported the benefit of cost savings compared to a traditional application cycle, with the most commonly reported estimated savings being $3,000–$5,000 per respondent. Conclusions These results allow recommendations for “best practices” for virtual interviews to include programs providing an electronic packet of information prior to the interview day, providing dedicated time for applicants to interact with current fellows, providing applicants an understanding of the city/region of the location of the program, and offering a completely optional postinterview visit, when possible. Based on the results of this survey, we recommend that programs continue to offer virtual interviews as a penalty‐free option for applicants, even when in‐person interviews may be feasible.
    Type of Medium: Online Resource
    ISSN: 1155-5645 , 1460-9592
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2008564-3
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 6
    In: Pediatric Anesthesia, Wiley, Vol. 32, No. 3 ( 2022-03), p. 471-478
    Abstract: The COVID‐19 pandemic created a situation with an urgent need to produce a virtual system for the 2019–2020 pediatric anesthesiology fellowship cycle. With fellowship interviews beginning in April 2020, there was minimal time for programs to adapt. Each program rapidly developed its own platform, expectations, materials, and process for interviews—all while under the stress of managing the unfolding patient care, financial, and leadership crises of the unfolding pandemic. Aims The aim of this survey‐based study was to help identify changes compared with previous traditional cycles, obstacles encountered, and program director attitudes toward this, and possible future, virtual application cycles. We separately report the results of an applicant‐based survey about the 2020 virtual interview cycle. Methods A 50‐question survey was developed utilizing Qualtrics. An anonymous survey link was sent to all pediatric anesthesiology program directors with an invitation for one program leader (either the program director or assistant/associate program director but not both) from each program to complete the voluntary survey. Result Thirty respondents completed the survey, for a response rate of 50% based on the 60 ACGME‐approved pediatric anesthesiology fellowships. Compared to previous traditional cycles, almost half of respondents (14/29, 48.3%) reported no increase in the number of applications received, and a majority of respondents (16/29, 55.2%) reported that they offered the same number of interview spots for the year. The virtual interview process appears to have gone smoothly, as a majority of programs reported they never or rarely had technical problems across a number of different domains. Importantly, the majority of respondents were either somewhat satisfied or extremely satisfied (21/28, 75%) with the overall virtual interview process. Given the choice of preferred interview format going forward, half of the respondents (14/28) would offer a combination of traditional and virtual interviews. Conclusions These results demonstrate that virtual interviews are a viable alternative to traditional interviews and can be completed without many technological complications. PDs were overall satisfied with virtual interviews, despite not having appropriate time to plan and coordinate, and would be interested in continuing this option into the future. There are areas where improvements can be made and with appropriate planning could look to mitigate some of the areas where virtual interviews fall short of traditional interviews. In combination with our previously published survey of applicants (Paediatr Anaesth. 2021;31(9):968–976), these data form a more complete picture of virtual interview best practices going forward.
    Type of Medium: Online Resource
    ISSN: 1155-5645 , 1460-9592
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2008564-3
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 7
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Pediatric Critical Care Medicine Vol. 23, No. 8 ( 2022-08), p. 646-650
    In: Pediatric Critical Care Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 23, No. 8 ( 2022-08), p. 646-650
    Abstract: To identify differences in emotional intelligence (EI)–related competencies between fellows and faculty in a cohort of pediatric critical care physicians. DESIGN: Single-center, cross-sectional observation study. SETTING: Seventy-two-bed multidisciplinary pediatric critical care unit at a quaternary children’s hospital (Children’s Hospital of Philadelphia, Philadelphia, PA). SUBJECTS: Forty-seven critical care physicians, including 19 fellows and 28 faculty members, were assessed. A multidisciplinary team of 83 physicians, nurses, and nurse practitioners contributed to the assessments. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A multirater EI assessment tool (Emotional and Social Competency Inventory 360) was used to measure EI competencies of participating physicians across 12 core competencies. Utilizing a priori scoring definitions, physician EI competencies were classified as strengths or areas for growth. Results were stratified based on provider experience, generating comparisons between fellow and faculty cohorts. Ninety-four percent (177/188) of distributed assessments were completed. Fellow strengths were identified as organization awareness, achievement orientation, and teamwork; areas for growth were influence and emotional self-awareness. Compared with fellows, faculty members demonstrated additional strengths in the domains of adaptability, emotional self-control, coach and mentor, positive outlook, inspirational leadership, and influence. CONCLUSIONS: This study provides the first characterization of EI competencies among trainees and faculty members using a validated multirater assessment tool. The descriptions of physician EI, based on years of experience, are an important piece of the foundation for future explorations into the advancement of physician EI and effective leadership.
    Type of Medium: Online Resource
    ISSN: 1529-7535
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2070997-3
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 8
    In: Otolaryngology–Head and Neck Surgery, Wiley, Vol. 151, No. 6 ( 2014-12), p. 1046-1054
    Abstract: Retrospective studies have limitations in predicting perioperative risk following adenotonsillectomy in children with obstructive sleep apnea syndrome (OSAS). Few prospective studies exist. We hypothesized that demographic and polysomnographic (PSG) variables would predict respiratory and general perioperative complications. Study Design Prospective, observational cohort study. Setting Pediatric tertiary center. Subjects and Methods Consecutive children undergoing adenotonsillectomy for OSAS within 12 months of PSG were evaluated for complications occurring within 2 weeks of surgery. Results There were 329 subjects, with 27% 〈 3 years old, 24% obese, 16% preterm, and 29% with comorbidities. In this higher risk population, 28% had respiratory complications (major and/or minor), and 33% had nonrespiratory complications. Significant associations were found between PSG parameters and respiratory complications as follows: apnea hypopnea index (rank‐biserial correlation coefficient [ r ] = 0.174, P =. 017), SpO 2 nadir ( r = −0.332, P 〈 . 0005), sleep time with SpO 2 〈 90% ( r = 0.298, P 〈 . 0005), peak end‐tidal CO 2 ( r = 0.354, P 〈 . 0005), and sleep time with end‐tidal CO 2 〉 50 mm Hg ( r = 0.199, P =. 006). Associations were also found between respiratory complications and age 〈 3 years ( r = −0.174, P =. 003) or black race ( r = 0.123, P =. 039). No significant associations existed between PSG parameters and nonrespiratory complications. A model using age 〈 3 years, SpO 2 nadir, and peak CO 2 predicted respiratory complications better than the American Academy of Pediatrics or American Academy of Otolaryngology—Head and Neck Surgery Foundation guidelines but was imperfect (area under the curve = 0.72). Conclusion Thus, PSG predicted perioperative respiratory, but not nonrespiratory, complications in children with OSAS. Age 〈 3 years or black race are high‐risk factors. Present guidelines have limitations in determining the need for postoperative admission.
    Type of Medium: Online Resource
    ISSN: 0194-5998 , 1097-6817
    Language: English
    Publisher: Wiley
    Publication Date: 2014
    detail.hit.zdb_id: 2008453-5
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 9
    In: British Journal of Anaesthesia, Elsevier BV, Vol. 131, No. 1 ( 2023-07), p. 178-187
    Type of Medium: Online Resource
    ISSN: 0007-0912
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
    detail.hit.zdb_id: 2011968-9
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 10
    In: Critical Care Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 48, No. 9 ( 2020-09), p. e744-e752
    Abstract: Bag-mask ventilation is commonly used prior to tracheal intubation; however, the epidemiology, risk factors, and clinical implications of difficult bag-mask ventilation among critically ill children are not well studied. This study aims to describe prevalence and risk factors for pediatric difficult bag-mask ventilation as well as its association with adverse tracheal intubation–associated events and oxygen desaturation in PICU patients. Design: A retrospective review of prospectively collected observational data from a multicenter tracheal intubation database (National Emergency Airway Registry for Children) from January 2013 to December 2018. Setting: Forty-six international PICUs. Patients: Children receiving bag-mask ventilation as a part of tracheal intubation in a PICU. Interventions: None. Measurements and Main Results: The primary outcome is the occurrence of either specific tracheal intubation–associated events (hemodynamic tracheal intubation–associated events, emesis with/without aspiration) and/or oxygen desaturation ( 〈 80%). Factors associated with perceived difficult bag-mask ventilation were found using univariate analyses, and multivariable logistic regression identified an independent association between bag-mask ventilation difficulty and the primary outcome. Difficult bag-mask ventilation is reported in 9.5% ( n = 1,501) of 15,810 patients undergoing tracheal intubation with bag-mask ventilation during the study period. Difficult bag-mask ventilation is more commonly reported with increasing age, those with a primary respiratory diagnosis/indication for tracheal intubation, presence of difficult airway features, more experienced provider level, and tracheal intubations without use of neuromuscular blockade ( p 〈 0.001). Specific tracheal intubation–associated events or oxygen desaturation events occurred in 40.2% of patients with reported difficult bag-mask ventilation versus 19.8% in patients without perceived difficult bag-mask ventilation ( p 〈 0.001). The presence of difficult bag-mask ventilation is independently associated with an increased risk of the primary outcome: odds ratio, 2.28 (95% CI, 2.03–2.57; p 〈 0.001). Conclusions: Difficult bag-mask ventilation is reported in approximately one in 10 PICU patients undergoing tracheal intubation. Given its association with adverse procedure–related events and oxygen desaturation, future study is warranted to improve preprocedural planning and real-time management strategies.
    Type of Medium: Online Resource
    ISSN: 0090-3493
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 2034247-0
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
Close ⊗
This website uses cookies and the analysis tool Matomo. Further information can be found on the KOBV privacy pages