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Kuchipudi YS, Rule A, Caldwell A, Fenchel M, Bosse D, Schuler CL, Jones YO. Pediatric Hospitalists' Performance of Recommended Minor Procedures: A Multicenter Study. Hosp Pediatr 2023; 13:1039-1047. [PMID: 37927058 DOI: 10.1542/hpeds.2023-007202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
BACKGROUND AND OBJECTIVES Performance of minor procedures is highly variable among pediatric hospitalists. Our objective was to describe procedural frequency and measure self-assessed competence in recommended minor procedures among practicing hospitalists. METHODS An electronic survey was administered across 20 US institutions. An individual survey assessed training, frequency, independence, and success in performing 11 minor procedures. The site survey described practice settings at participating study sites. The primary outcome was respondents' self-assessed competence (SAC), derived by averaging self-assessed independence and success scores (each on a 5-point Likert scale) across all 11 minor procedures. Associations between predictor variables and SAC were determined through analysis of variance for categorical variables and fitted regression models for continuous variables. RESULTS Of the 360 survey respondents, the majority were female (70%), not fellowship trained (78%), and had 10 years or fewer experience as a hospitalist (72%). Lumbar puncture and bag mask ventilation were most frequently performed. Greater procedural frequency and time since graduation from training were associated with higher SAC scores among respondents. Practice characteristics, including comanagement of patients and reserved time for practicing procedures, were associated with higher SAC scores. The presence of a simulation center and fellowship program was not associated with higher SAC scores. CONCLUSIONS Pediatric hospitalists that performed procedures more frequently had higher self-assessed procedural competence. Tailored opportunities with increased hands-on experience in performing minor procedures may be important to develop and maintain procedural skills.
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Affiliation(s)
| | - Amy Rule
- Divisions of Neonatology and Hospital Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia
- Department of Pediatrics, Emory School of Medicine, Atlanta, Georgia
| | - Alicia Caldwell
- Divisions of Hospital Medicine
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Matthew Fenchel
- Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | | | - Christine L Schuler
- Divisions of Hospital Medicine
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Yemisi O Jones
- Divisions of Hospital Medicine
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
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Lynch JD, Lancaster J, Jones YO, Andrews AL. A curious case to keep you awake at night. J Hosp Med 2023; 18:262-266. [PMID: 36176047 DOI: 10.1002/jhm.12970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 07/20/2022] [Accepted: 09/08/2022] [Indexed: 11/07/2022]
Affiliation(s)
- Joseph D Lynch
- Department of Pediatrics, Division of Pediatric Hospital Medicine, West Virginia University, Morgantown, West Virginia, USA
| | - Jeffrey Lancaster
- Department of Pediatrics, Division of Pediatric Hospital Medicine, West Virginia University, Morgantown, West Virginia, USA
| | - Yemisi O Jones
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Annie L Andrews
- Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina, USA
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Herrmann LE, Jones YO, Kinnear B, Rule A, Piper L, Shah SS, Klein M. Development and evaluation of a pediatric hospital medicine board review course. BMC Med Educ 2022; 22:804. [PMID: 36402975 PMCID: PMC9675241 DOI: 10.1186/s12909-022-03862-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 11/03/2022] [Indexed: 05/27/2023]
Abstract
BACKGROUND The American Board of Medical Specialties recognized Pediatric Hospital Medicine (PHM) for subspecialty certification in 2016, with the first certification exam in 2019. To address the need for exam preparatory materials, we designed and evaluated a novel PHM board review course that was offered both in-person and online. METHODS Course content was based on the American Board of Pediatrics (ABP) PHM certifying exam outline. Course objectives were developed from published PHM core competencies and the 2012 ABP general pediatrics content objectives. National experts served as faculty, presenting didactic sessions, and contributing to a question bank for high-yield review. For program evaluation, we applied the Kirkpatrick Model, evaluating estimated exam pass rates (Level 4), participant learning (Level 2) via post-presentation practice questions, and participants' ratings of presenters (via five-point Likert scale) and satisfaction (Level 1). RESULTS There were 112 in-person and 144 online participants with estimated pass rates of 89 and 93%, respectively. The mean correct response for the post-presentation knowledge questions was 84%. Faculty effectiveness ratings ranged from 3.81 to 4.96 (median score 4.60). Strengths included the pace of the course, question bank, and printed syllabus. Suggestions for improvement included question bank expansion, focus on "testable" points rather than general information, and challenges with long days of didactic presentations. CONCLUSIONS This novel PHM board review course demonstrated effectiveness. Hospitalists preferred focused "testable" information, an active learning environment, and a robust question bank. Future preparatory courses should consider including more opportunities for practice questions, focused content review, and learner engagement.
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Affiliation(s)
- Lisa E Herrmann
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
| | - Yemisi O Jones
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Benjamin Kinnear
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Amy Rule
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Laura Piper
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Samir S Shah
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Melissa Klein
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of General Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Jones YO, Shah SS. The pernicious problem of physician turnover in hospital medicine. J Hosp Med 2022; 17:856-857. [PMID: 36138413 DOI: 10.1002/jhm.12964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 08/29/2022] [Accepted: 08/30/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Yemisi O Jones
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Division of Hospital Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Samir S Shah
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Division of Hospital Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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Jones YO, Hubbell BB, Thomson J, O’Toole JK. Things We Do for No Reason: Systemic Corticosteroids for Wheezing in Preschool-Aged Children. J Hosp Med 2019; 14:774-776. [PMID: 31339838 PMCID: PMC6897538 DOI: 10.12788/jhm.3255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Wheezing is common in preschool-aged children (ages 2-5
years), with up to half in this age group having experienced a
wheezing episode and up to one-third, recurrent wheezing.1,2
Young children with wheezing require ED visits and hospitalizations
at much higher rates than older children and adults.3 Several
studies have also demonstrated that children in this age
group have higher rates of SCS prescriptions compared with
older children.4,5 Despite the high prevalence of wheezing in
this age group, there is great heterogeneity in the etiology and
clinical progression of early childhood wheezing, with up to six
described phenotypes each with varying levels of association
with the development of asthma.6 Given the high frequency of
asthma, preschool-aged children admitted with wheezing are
often treated with SCS, as this is the standard of care for an
acute asthma exacerbation.7
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Affiliation(s)
- Yemisi O Jones
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
- Corresponding Author: Yemisi O Jones, MD; E-mail: ; Telephone: 412-965-9630
| | - Brittany B Hubbell
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Joanna Thomson
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Jennifer K O’Toole
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
- University of Cincinnati Medical Center, Cincinnati, Ohio
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