COMSEP 2008 Atlanta Meeting
Weighing In: Addressing the Lack of Medical Student Exposure to Performance of Basic Pediatric Skills.
M. Schechter, J. R. Avner.
Albert Einstein College of Medicine / Children’s Hospital at Montefiore, Bronx, NY
OBJECTIVE: There are many basic and common procedures in pediatrics that, while usually performed by nurses, are important skills for doctors to master. These procedural skills are included in the AAMC Recommendations for Clinical Curricula for Under-graduate Medical Education. Yet, medical students (MS) and residents often lack opportunities to become proficient in these tasks. We sought to assess the experience our pediatric housestaff had as MS in learning these procedures and institute a program designed to utilize the expertise of pediatric nurses to teach 4th year medical students (MS4s) how to perform these procedures.
METHODS: We surveyed our pediatric housestaff as to whether they received instruction on, and/or actually performed, selected common pediatric procedures as MS. These tasks included measurement of weight, length, height, head circumference, blood pressure, temperature and oxygen saturation, as well as administration of vision and hearing screens, vaccines and oxygen. We also instituted an educational module to teach these skills to MS4s during their Pediatric Ambulatory Rotation. Each student spends a full 4-hour patient care session in a busy academic community health center with an experienced LPN. Initially the student is instructed in and observes the nurse performing these common procedures during the course of routine patient care. The student is then given the opportunity to perform these tasks under the supervision of the nurse. At the end of the session, the nurse and student complete a checklist of proficiently performed items.
RESULTS: 38(63%) of 60 residents responded to the survey. A minority had been taught and had performed infant and child measurements(30%), vision(29%) and hearing(3%) screens, temperature measurement(21%), vaccine administration(50%) or oxygen administration(47%) as MS. For the 10 MS4s in the program who submitted checklists, all learned and proficiently performed anthropometric and temperature measurements and 8 administered vaccines and hearing and vision screens.
CONCLUSIONS: A majority of our housestaff had not learned or performed many basic pediatric procedures in medical school. Using an interdisciplinary and hands-on approach, MS4s received instruction and experience in performing some basic, but important, common procedures in pediatrics; skills which will be valuable to them as they enter pediatric residency and practice.