Ilana Harwayne-Gidansky, MA, MD (she/her/hers)
Associate Professor of Pediatrics
Bernard and Millie Duker Children's Hospital at Albany Medical Center
Albany, NY
Disclosure information not submitted.
Lee Polikoff, MD (he/him/his)
Hasbro Children's Hospital
Providence, Rhode Island
Disclosure information not submitted.
Matthew Malone, MD,
Assistant Professor of Pediatrics
University of Arkansas for Medical Sciences Arkansas Childrens Hospital
Little Rock, United States
Disclosure information not submitted.
Lily Glater-Welt, MD, (she/her/hers)
Assistant Professor
Cohen Children's Medical Ctr of NY
New Hyde Park, NY
Disclosure information not submitted.
Christopher Page-Goertz, MD
Assistant Professor
Akron Childrens Hospital, United States
Disclosure information not submitted.
Matthew Pinto, MD
Assistant Professor
Maria Fareri Children's Hospital At Westchester Medical Center
Valhalla, New York, United States
Disclosure information not submitted.
Sholeen Nett, MD, PhD
professor
Childrens Hospital at Dartmouth, United States
Disclosure information not submitted.
.jpg "Vinay Nadkarni, MD, MS, FCCM (he/him/his) photo")
Vinay Nadkarni, MD, MS, FCCM (he/him/his)
Professor, Anesthesiology, Critical Care and Pediatrics
University of Pennsylvania Perelman School of Medicine, CHOP
Media, Pennsylvania, United States
Disclosure information not submitted.
Akira Nishisaki, MD, MSCE
Associate Professor of Anesthesia and Critical Care Medicine
The Children's Hospital of Philadelphia, United States
Disclosure information not submitted.
Title: Resident Education of the NEAR4KIDS Airway bundle: Validation of a Scoring Tool
Introduction: Recently, resident physician tracheal intubation (TI) experiences have declined. Current ACGME guidelines do not require Pediatrics residents to perform TIs outside of the NICU. They are instead expected to identify patients at-risk for respiratory failure, and anticipate and prepare for, rather than perform, TI. Targeted education has not been well studied in this population, and no validated assessment tool exists. We created a resident-focused education toolkit including a knowledge assessment of the National Emergency Airway for Children (NEAR4KIDS) Airway Bundle Checklist. We hypothesize our de novo assessment tool demonstrates validity using Kane’s framework.
Methods: The educational toolkit consists of three components: (1) flipped classroom didactic, (2) experiential learning during the PICU resident rotation, and (3) simulation-based assessment at the end of the PICU rotation. Rater calibration was performed with 10 subjects; 2 raters per subject rated the airway bundle assessment tool based upon a standardized patient vignette. To measure the effectiveness of this toolkit, we created and validated a knowledge assessment test. The NEAR4KIDS airway bundle checklist was modified to function as the assessment tool in the REDCap. A focus group of 6 subject matter experts determined content validity and scoring criteria through a modified Delphi process. Scoring was chosen as dichotomous variables (correct/incorrect) through general consensus of the experts. Each resident scores were normalized to % correct. Kane’s argument for validity was used to further validate this tool through scoring, extrapolation, and implication by consensus of the experts. Sign-rank test was used to evaluate changes in normalized score before vs. after PICU rotation.
Results: Ten subjects participated in the calibration cohort. There was 100% agreement between raters. In the pilot cohort of residents (n=7), there was a significant increase in the score from baseline to the end of PICU rotation (median 87% [IQR 87-93] vs. 93% [IQR 93-100] p=0.03).
Conclusions: An educational toolkit teaching residents how to anticipate and prepare for TI is both feasible and valid. In the future, we will evaluate the effect of this toolkit on knowledge, completion of all components, and cognitive load.