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AbstractObjectives: Pediatric emergency medicine (PEM) physicians receive little opportunity to practice and perform chest tube insertion. We sought to develop and validate a scoring tool to assess chest tube insertion competency and identify areas where training is required for PEM physicians.Methods: We developed a 40-point, 20-item (scored 0, 1, or 2) assessment tool entitled the Tool for Assessing Chest Tube Insertion Competency (TACTIC) and studied how PEM physicians and fellows scored when inserting a chest tube into a pork rib model. Participants were scored at baseline and compared to themselves after receiving targeted training using Web-based animations and presentations followed by expert instruction and practice on chest tube insertion task trainers. All insertions were video recorded and reviewed by two blinded reviewers. Eight common videos were reviewed to assess interrater reliability.Results: The TACTIC demonstrated good interrater reliability with an r2=0.86. Our cohort demonstrated a significant improvement in TACTIC scores by taking part in targeted training (precourse TACTIC=65%, 95% CI 54–76 v. postcourse TACTIC=84%, 95% CI 80–88), highlighting the construct validity of the TACTIC. Individual participants increased their TACTIC scores by an average of 17%.Conclusions: The TACTIC demonstrates good interrater reliability, content validity, and construct validity in assessing a PEM practitioner’s skill inserting chest tubes in a simulated setting.

Canadian subspecialty residency training programs are developed around the learning objectives listed in the seven Canadian Medical Education Directives for Specialists (CanMEDS) criteria. Delivering content on objectives outside of those traditionally acquired in clinical rotations can be a challenge. In the present article, the planning process, curriculum development, and evaluation and assessment of a national subspecialty conference model in providing CanMEDS objective-based content sessions in the categories other than Medical Expert (Professional, Scholar, Communicator, Collaborator, Manager and Health Advocate) is described. It is hypothesized that the development of a CanMEDS objective-based curriculum would be positively received by subspecialty residents attending this conference. Attendees of sessions in a two-year curriculum cycle assessed the content as valuable, relevant and effective. The application of this process can be useful to other subspecialty residency training programs to meet the needs of their CanMEDS objective-based training requirements.

The primary objective was to examine the effects of a simulated observation unit (OU) and a transfer mandate for admitted patients on pediatric emergency department (PED) patient flow indicators. The secondary objective was to report on the occupancy rate of the simulated OU.

Quality assurance is a new and important area of research in pediatric emergency medicine (PEM). There are few studies that describe which performance indicators best represent the PEM practice. The primary study objective is to construct a set of performance indicators that have been selected by current and former pediatric emergency department (PED) medical directors as most useful in assessing PED performance. The secondary objective is to assess which indicators are currently measured to assess performance in PEDs.

Increasing patient census and department overcrowding are universal concerns in pediatric emergency medicine. Accurate predictions of patient flow and resource utilization in the pediatric emergency department (PED) are important in determining what aspects of PED activity could be modified to improve patient flow, reduce patient waiting times, and increase staff efficiency and morale, and thus direct change more effectively.

Radiofrequency identification (RFID) technology has been used in other emergency department settings but has not been assessed in a pediatric emergency department setting for its reliability in its application as a patient tracking system. The goal of this study was to assess the accuracy, precision, and reliability of the technology in a simulated pediatric emergency department setting to collect patient tracking information.