Learning to competently and compassionately perform procedures is one of the most challenging things to master in pediatric training. At CHOP, multiple approaches are used to gain competency in performing procedures.
Didactic sessions and workshops are used as early as Intern Orientation to develop competence and confidence in the procedural skills residents need to master. Pediatric Advanced Life Support (PALS) and the Neonatal Resuscitation Program (NRP) are offered during orientation. Suture and splinting workshops are also provided by the division of Emergency Medicine early in the first year.
Ongoing procedural practice is provided in a variety of settings:
The Division of Emergency Medicine holds an annual resuscitation day for first-year residents. This day-long event focuses on procedural skills and resuscitation scenarios using didactic, small group and workshop settings. The goal is to reinforce and refresh these concepts before undertaking the large number of acute care rotations (ED, PICU and NICU) that are part of the second year curriculum.
In a variety of rotations, housestaff are instructed in procedural skills and supervised by experienced nurses, senior housestaff, fellows and attendings while they are performing procedures. Primary care sessions, ED, inpatient unit, PICU, NICU, transport and sedation service rotations expose residents to a wide range of minor and complex procedures throughout their training.
Delivery room experience and resuscitations are an integral part of the NICU rotations at the Hospital of the University of Pennsylvania (HUP).
The management of minor trauma, including laceration care and splinting, is taught in the ED. Residents actively participate in and perform procedures during resuscitations in the ED, PICU and NI/ICU. Throughout a residents training, she’ll have the opportunity to perform lumbar punctures, procedural sedation, intravenous line insertion and all other routine pediatric procedures.
As critical procedures become rarer in pediatric practice, reliance on simulation technology as a means of providing valuable experiences will continue to increase. Sessions on how to teach procedures are being developed for and offered to senior housestaff.