A Human Trafficking Educational Program and Point-of-Care Reference Tool for Pediatric Residents.
Ontology highlight
ABSTRACT: Introduction
Trafficked youth experience complex health issues such as substance abuse, severe physical trauma, and sexual health problems, with many entering trafficking between 15 and 17 years old. There is increasing awareness of the need to educate pediatric health care providers on identifying and aiding trafficked children; however, critical gaps in the literature exist regarding educational sessions specific to the human trafficking of pediatric patients. Our objective was to implement and evaluate a survivor-informed educational session for pediatric resident physicians to improve identification of and assistance to trafficked youth in the clinical setting.Methods
We designed an educational session on human trafficking, which included a 60-minute interactive didactic presentation and distribution of a point-of-care reference tool, in collaboration with a survivor of human trafficking, for 59 pediatric trainees in 2019. We utilized pre/post knowledge assessments. Data analysis included descriptive statistics and Fisher exact analysis.Results
Of 99 total eligible residents, 59 (59%) participated. Statistically significant increases in correct identification of hypothetical trafficked youth and next steps for intervention were observed. Over 80% of participants reported comfort with defining, recognizing, referring to, and understanding health consequences of human trafficking on the postassessment, compared to 25% on the preassessment (p < .001).Discussion
Our educational session resulted in statistically significant increased comfort in identification of human trafficking victims and can be replicated at other institutions. The point-of-care reference tool-which can be adapted for use in different settings-can guide pediatric residents in managing suspected trafficked youth in the clinical setting.
SUBMITTER: Garg A
PROVIDER: S-EPMC8435556 | biostudies-literature |
REPOSITORIES: biostudies-literature
Similar Datasets
Project description:Introduction:Point-of-care ultrasound (POCUS) is ultrasound performed by the provider at the patient's bedside to answer a specific clinical question. No guidelines exist for teaching POCUS to pediatric residents, and there are currently no pediatric-specific POCUS resources on MedEdPORTAL. To fill this gap, we designed an educational resource to introduce pediatric residents to POCUS during their pediatric intensive care unit (PICU) rotation. Methods:Our POCUS curriculum included content on ultrasound basics, lung ultrasound, and focused cardiac ultrasound. Residents completed a precourse knowledge test at the start of the PICU rotation. Self-study modules were provided to the residents for independent review. During small group, residents performed ultrasound scanning on subjects with normal anatomy. Residents also participated in weekly POCUS rounds to perform supervised ultrasound scanning on PICU patients with known abnormal ultrasound findings. After completion of the PICU rotation, residents competed a postcourse knowledge test and survey. Knowledge test scores were compared to a historical cohort of residents who had completed the PICU rotation but not the POCUS curriculum. Results:Six residents completed the curriculum, and all completed the postcourse knowledge test with significant improvement in test scores compared to a historical cohort. Residents reported increased knowledge of POCUS indications and comfort performing POCUS. All residents rated the small-group sessions and POCUS rounds highly. Discussion:Pediatric residents have little POCUS training and perform poorly on POCUS knowledge testing. A basic POCUS curriculum can be instituted during the PICU rotation and improve resident knowledge and comfort with POCUS.
| S-EPMC6342342 | biostudies-other
Project description:BackgroundTraining programs on resuscitation have been developed using simulation-based learning to build skills, strengthen cognitive strategies, and improve team performance. This is especially important for residency programs where reduced working hours and high numbers of residents can reduce the educational opportunities during the residency, with lower exposure to practical procedures and prolonged length of training. Within this context, gamification has gained popularity in teaching and learning activities. This report describes the implementation of a competition format in the context of newborn resuscitation and participants' perceptions of the educational experience.MethodsThirty-one teams of three Italian pediatric residents participated in a 3-day simulation competition on neonatal resuscitation. The event included an introductory lecture, familiarization time, and competition time in a tournament-like structure using high-fidelity simulation stations. Each match was evaluated by experts in neonatal resuscitation and followed by a debriefing. The scenarios and debriefings of simulation station #1 were live broadcasted in the central auditorium where teams not currently competing could observe. At the end of the event, participants received an online survey regarding their perceptions of the educational experience.Results81/93 (87%) participants completed the survey. Training before the event mostly included reviewing protocols and textbooks. Low-fidelity manikins were the most available simulation tools at the residency programs. Overall, the participants were satisfied with the event and appreciated the live broadcast of scenarios and debriefings in the auditorium. Most participants felt that the event improved their knowledge and self-confidence and stimulated them to be more involved in high-fidelity simulations. Suggested areas of improvement included more time for familiarization and improved communication between judges and participants during the debriefing.ConclusionsParticipants appreciated the simulation competition. They self-perceived the educational impact of the event and felt that it improved their knowledge and self-confidence. Our findings suggest areas of improvements for further editions and may serve as an educational model for other institutions.
| S-EPMC10605553 | biostudies-literature
Project description:BackgroundPOCUS is a growing field in medical education, and an imaging modality ideal for children given the lack of ionizing radiation, ease of use, and good tolerability. A 2019 literature review revealed that no US pediatric residency programs integrated obligatory POCUS curricula. Our objective was to provide a formalized POCUS curriculum over multiple years, and to retrospectively assess improvement in resident skills and comfort.MethodsDuring intern year, pediatric residents received didactics and hands-on scanning opportunities in basic POCUS applications. Their evaluation tools included pre- and post-surveys and tests, and a final performance exam. In the second and third years of residency, all participants were required to complete 8 hours per year of POCUS content review and additional hands-on training. An optional third-year curriculum was offered to interested residents as career-focused education elective time.ResultsOur curriculum introduced POCUS topics such as basic and advanced cardiac, lung, skin/soft tissues and procedural based ultrasound to all pediatric residents. Among first-year residents, application-specific results showed POCUS comfort level improved by 61-90%. Completed evaluations demonstrated improvement in their ability to recognize and interpret POCUS images. Second- and third-year residents reported educational effectiveness that was rated 3.9 on a 4-point Likert scale. Four third-year residents took part in the optional POCUS elective, and all reported a change in their practice with increased POCUS incorporation.ConclusionsOur longitudinal pediatric residency POCUS curriculum is feasible to integrate into residency training and exhibits early success.
| S-EPMC7816421 | biostudies-literature
Project description:BackgroundDespite strong evidence of benefit, breast cancer risk assessment and chemoprevention are underutilized by primary care physicians. This study evaluates the impact of an educational program on knowledge and utilization of the NCI Breast Cancer Risk Assessment Tool (BCRAT) by internal medicine residents.MethodsInternal medicine residents at the primary care clinic at William Beaumont Hospital participated in an educational program on breast cancer risk assessment and chemoprevention. A questionnaire was used to assess knowledge and practice before and after participation. Electronic health records of women between the ages of 35 and 65 who were seen by participating residents for annual health exams between Dec 15, 2015 and Dec 14, 2016 were reviewed. Utilization of BCRAT by the residents was compared pre- and post-educational program.ResultsA total of 43 residents participated in the study. 31 (72.1%) residents reported no prior knowledge about BCRAT. The remaining 12 (27.9%) reported limited knowledge of BCRAT, but the majority of these (n = 10, 83.3%) had not used it in the last six months. For each question on the pre-educational knowledge assessment, fewer than 10% of the residents responded correctly. After implementation of the educational program, there was a significant increase in the proportion of residents who answered correctly (Range: 67 to 100%, p < 0.001). Electronic health records of 301 clinic patients were reviewed, 118 (39.2%) in the pre-educational program group and 183 (60.8%) in the post-educational program group. There was a higher use of BCRAT in the post-educational program group compared to the pre-intervention group (3.8% vs. 0%, p < 0.05). However, a majority (n = 294, 98.7%) of eligible patients from both groups did not undergo breast cancer risk assessment.ConclusionsOur study demonstrates that an educational intervention improved residents' knowledge of BCRAT. Despite this improvement, a significant proportion of patients did not undergo breast cancer risk assessment. Expanding the scope and duration of this intervention and combining it with innovative use of technology to improve utilization should be the subject of future investigation.
| S-EPMC6416938 | biostudies-literature
Project description:BackgroundPoint-of-care ultrasound (POCUS) has become an essential tool for anaesthesia and critical care physicians and dedicated training is mandatory. This survey describes the current state of Italian residency training programs through the comparison of residents' and directors' perspective.MethodsObservational prospective cross-sectional study: 12-question national e-survey sent to Italian directors of anaesthesia and critical care residency programs (N = 40) and residents (N = 3000). Questions focused on POCUS teaching (vascular access, transthoracic echocardiography, focused assessment for trauma, transcranial Doppler, regional anaesthesia, lung and diaphragm ultrasound), organization (dedicated hours, teaching tools, mentors), perceived adequacy/importance of the training and limiting factors.ResultsFive hundred seventy-one residents and 22 directors completed the survey. Bedside teaching (59.4-93.2%) and classroom lessons (29.7-54.4%) were the most frequent teaching tools. Directors reported higher participation in research projects (p < 0.05 for all techniques but focused assessment for trauma) and simulation (p < 0.05 for all techniques but transthoracic echocardiography). Use of online teaching was limited (< 10%); however, 87.4% of residents used additional web-based tools. Consultants were the most frequent mentors, with different perspectives between residents (72.0%) and directors (95.5%; p = 0.013). Residents reported self-training more frequently (48.5 vs. 9.1%; p < 0.001). Evaluation was mainly performed at the bedside; a certification was not available in most cases (< 10%). Most residents perceived POCUS techniques as extremely important. Residents underestimated the relevance given by directors to ultrasound skills in their evaluation and the minimal number of exams required to achieve basic competency. Overall, the training was considered adequate for vascular access only (62.2%). Directors mainly agreed on the need of ultrasound teaching improvement in all fields. Main limitations were the absence of a standardized curriculum for residents and limited mentors' time/expertise for directors.ConclusionPOCUS education is present in Italian anaesthesia and critical care residency programs, although with potential for improvement. Significant discrepancies between residents' and directors' perspectives were identified.
| S-EPMC9420188 | biostudies-literature
Project description:BackgroundEducators in all disciplines recognize the need to update tools for the modern learner. Mobile applications (apps) may be useful, but real-time data is needed to demonstrate the patterns of utilization and engagement amongst learners.MethodsWe examined the use of an anesthesia app by two groups of learners (residents and anesthesiologist assistant students [AAs]) during a pediatric anesthesiology rotation. The app calculates age and weight-based information for clinical decision support and contains didactic materials for self-directed learning. The app transmitted detailed usage information to our research team.ResultsOver a 12-month period, 39 participants consented; 30 completed primary study procedures (18 residents, 12 AAs). AAs used the app more frequently than residents (P = 0.025) but spent less time in the app (P < 0.001). The median duration of app usage was 2.3 minutes. During the course of the rotation, usage of the app decreased over time. 'Succinylcholine' was the most accessed drug, while 'orientation' was the most accessed teaching module. Ten (33%) believed that the use of apps was perceived to be distracting by operating room staff and surgeons.ConclusionsReal-time in-app analytics helped elucidate the actual usage of this educational resource and will guide future decisions regarding development and educational content. Further research is required to determine learners' preferred choice of device, user experience, and content in the full range of clinical and nonclinical purposes.
| S-EPMC5995022 | biostudies-literature
Project description:BACKGROUND:Musculoskeletal point of care ultrasound (MSK POCUS) has many uses for orthopaedic surgeons, but orthopaedic trainees are rarely exposed to this modality. The purpose of this project was to assess the usefulness in clinical education of a newly implemented MSK POCUS course in an orthopaedic surgery program. METHODS:An MSK POCUS course for orthopaedic surgery residents was developed by an interdisciplinary team. Online videos were created to be viewed by residents prior to a half-day long practical course. An online survey covering the level of training of the resident and their previous use of ultrasound (total hours) was completed by the participants prior to the course. Resident's knowledge acquisition was measured with written pre-course, same-day post-course and six-month follow-up tests. Residents were also scored on a practical shoulder examination immediately after the course and at six-month follow-up. Changes in test scores between time points were evaluated using Wilcoxon signed-rank tests. RESULTS:Ten orthopaedic surgery residents underwent the MSK POCUS curriculum. Pre-course interest in MSK-POCUS was moderate (65%) and prior exposure was low (1.5?h mean total experience). Written test scores improved significantly from 50.7?±?17.0% before to 84.0?±?10.7% immediately after the course (p?<?0.001) and suffered no significant drop at 6 months (score 75.0?±?8.7%; p?=?0.303). Average post-course practical exam score was 78.8?±?3.1% and decreased to 66.2?±?11.3% at 6 months (p?=?0.012). Residents significantly improved their subjective comfort level with all aspects of ultrasound use at 6 months (p?=?0.007-0.018) but did not significantly increase clinical usage frequency. CONCLUSION:An MSK POCUS curriculum was successfully developed and implemented using an interdisciplinary approach. The course succeeded in improving the residents' knowledge, skills, and comfort with MSK POCUS. This improvement was maintained at 6 months on the written test but did not result in higher frequency of use by the residents.
| S-EPMC6937626 | biostudies-literature
Project description:IntroductionPoint-of-care ultrasound (POCUS) is an increasingly used bedside tool. Applications in urology include the assessment of an undifferentiated acute scrotum, renal colic, and the guidance of suprapubic catheter placement. However, the user-dependent nature of this modality necessitates appropriate use and competence. The objective of this study was to develop and evaluate a low-cost, feasible, and guideline-based introductory POCUS program for Canadian urology residents.MethodsResidents from McMaster University's urology program completed a three-hour online course, followed by a three-hour hands-on seminar. Course material was developed by ultrasound educators based on national guidelines. Low-cost testicular phantoms and suprapubic catheter insertion models were constructed. Pre- and post-course surveys focused on participant skill confidence, while multiple-choice questionnaires assessed theoretical knowledge.ResultsFourteen residents participated in the course. Theoretical knowledge in POCUS improved significantly (p<0.001, d=2.2) and mean confidence scores improved for all skills, including performing kidney, bladder, and testicular POCUS (all p<0.001; d=3.4, 1.9, 2.9, respectively). Participants indicated that the course increased their confidence and likelihood of using POCUS in clinical practice, and that POCUS training should be integrated into urology training curricula.ConclusionsThis novel study included the development of an inexpensive, feasible, guideline-based introductory training program for urological POCUS, developed in collaboration with ultrasound educators. Participants significantly improved in theoretical knowledge and skill confidence. Although this study was limited to one residency program, the basis of this course may serve as a foundation for the development of competency-based training for urological POCUS in Canada.
| S-EPMC8021428 | biostudies-literature
Project description:IntroductionConsistent medical knowledge acquisition while caring for the critically ill can be challenging for learners and educators in the pediatric intensive care unit (PICU), a unit often distinguished by fluctuating acuity and severity. We implemented a standardized didactic curriculum for PICU residents to facilitate their acquisition and retention of knowledge in core PICU topics.MethodsWe developed a comprehensive standardized curriculum for PGY 2-PGY 4 PICU pediatric and internal medicine-pediatric residents. Thirteen core topics were administered as 30-minute didactic sessions during the rotation, using either PowerPoint slides or a dry-erase board. Residents were tested to assess knowledge acquisition and retention.ResultsSeventy-eight residents participated, 86% of whom completed posttests. Seventeen percent completed follow-up tests. Of the learners who participated, 60 (77%) completed pretests and posttests, indicating their confidence level each time. The pretest mean was 55% (SD = 14.4%), and the posttest mean was 64% (SD = 15.6%). This 9% increase was statistically significant (p = .001; CI, 3.9% to 14.8%). The follow-up test at 3 months, completed by 15% of this subgroup, demonstrated a mean score of 62% (SD = 14.5%). When matched with posttest scores (mean score of 64%, SD = 13.3%), there was no significant difference (p = .7398; CI, -11.7% to 16.2%), suggesting retention of previously acquired knowledge.DiscussionOur standardized didactic curriculum effectively facilitated the acquisition and retention of the medical knowledge of core PICU topics among PICU residents, in addition to their usual experiential learning.
| S-EPMC7566227 | biostudies-literature
Project description:IntroductionThe use of point-of-care ultrasound (POCU) is increasing globally. However, owing to the epidemiology of diseases and local management strategies, POCU may not be universally applicable. Before developing a POCU training program, because of limited resources for medical education, it was pivotal to conduct a needs assessment and identify the training barriers.MethodsThis study used a validated paper questionnaire. The survey instrument was distributed to 120 pediatric residents (male 60, female 60) training at our institution to assess their self-reported level of skill in POCU, and their perceptions with regard to the applicability of POCU, measured with a 5-point Likert scale. The skills deficit was measured by subtracting the self-reported level of skills in lung, cardiac, and abdominal POCU from the perceived applicability of POCU.ResultsFifty-nine residents participated, resulting in a response rate of 50 and 48% (n = 29) for the male group, and 50% (n = 30) for the female group. The level of knowledge and proficiency was low. Scanning for free abdominal fluid was deemed the most applicable (mean 4.2 ± SD 1.1); however, the use of POCU to detect consolidation was considered least applicable (mean 2.7 ± SD 1.3). The skills deficit was highest for an abdominal POCU (mean 2.4 ± SD 1.6) and lowest for lung ultrasound (mean 1.4 ± SD 1.6). Although the majority (n = 48) agreed that this skill was essential, 3 (5%) had no interest, and 39% (n = 23) indicated a lack of time to acquire the skill.ConclusionsThough pediatric residents in Saudi Arabia agree that POCU is an essential skill, large skill deficits exist, supporting the necessity to provide POCU training. However, there are several barriers to overcome to achieve this.
| S-EPMC9072245 | biostudies-literature